Open AccessEvaluations of Hospitalizations Associated With Thiazide‐Associated Hyponatremia
Author(s) -
Rastogi Divaker,
Pelter Mitchell A.,
Deamer Robert L.
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2011.00575.x
Subject(s) - medicine , thiazide , hypokalemia , hyponatremia , odds ratio , diabetes mellitus , type 2 diabetes , risk factor , kidney disease , blood pressure , endocrinology
J Clin Hypertens (Greenwich) . 2012;14:158–164. ©2012 Wiley Periodicals, Inc. The prevalence of hypertension in the United States has grown dramatically in recent years. Thiazide diuretics have played a major role in the rising rate of blood pressure (BP) control. Accompanying this has been the appearance of adverse drug events, including hospitalizations associated with thiazide‐associated hyponatremia (HTAH). Hyponatremia is a common yet often overlooked side effect of this drug class. Identification of HTAH risk factors may aid in creating strategies to prevent hospitalizations. This is a retrospective, case‐controlled study of 10,805 patients (1802 cases, 9003 controls) examining HTAH risk factors within a group‐model integrated‐care organization. Multivariate analysis revealed that age (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.58–1.93), angiotensin‐converting enzyme (ACE) inhibitor use (OR, 1.53; 95% CI, 1.16–2.00), and hypokalemia (OR, 40.94; 95% CI, 26.46–66.33) were most associated with HTAH. Urinary tract infection (UTI), type 2 diabetes, hyperlipidemia, and gastroesophageal reflux disease (GERD) were also found to be HTAH risk factors. Potassium supplements (OR, 0.60; 95% CI, 0.44–0.83) and weight (OR, 0.91; 95% CI, 0.88–0.93) had protective effects. A predictive model was developed to determine overall HTAH risk given the presence of individual risk factors. Age, weight, hypokalemia, GERD, type 2 diabetes, UTI, and ACE inhibitor use independently correlated with an increased risk of HTAH. This model may be applied in clinical practice to guide thiazide prescribing.