OBJECTIVE: To confirm and quantify any association between spironolactone
and upper gastrointestinal bleeding and ulcers. DESIGN: Population based
case-control study. SETTING: A primary care information database in the
Netherlands. PARTICIPANTS: All people on the database who were aged 18 or
more between 1 January 1996 and 30 September 2003. Patients with a history
of alcoholism or gastrointestinal cancer were excluded. Ten controls were
matched to each case of gastroduodenal ulcer or upper gastrointestinal
bleeding by age (year of birth), sex, and index date. MAIN OUTCOME
MEASURES: The occurrence of an upper gastrointestinal event (bleeding or
ulcers), adjusted for potential confounders with conditional logistic
regression analysis. RESULTS: Within the source population of 306 645
patients, 523 cases of gastric or duodenal ulcer or upper gastrointestinal