Title: Hydrochlorothiazide and Chlorthalidone Induced Hyponatremia – A Comparative Analysis for Concern
Authors: Gantait K, Ghosh TP, Gantait I, Patra S, Bhunia P
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.15
Abstract
Thiazide diuretics like hydrochlorothiazide (HCTZ) and chlorthalidone (CT) are commonly used pharmacol-ogical agents for the treatment of hypertension preferably in elderly patients. Previously we ignored risk of hyponatremia following diuretics therapy but much more attention paid to prevent hypokalemia. In this study we are giving more attention to the fact that hyponatremia is developed after the use of low dose of HCTZ & CT in hypertensive elderly patient. We reviewed the list of hypertensive patients hospitalized in Midnapore Medical College for hyponatremia from January 2015 to December 2015. We identified 40 (19M/21F) hypertensive patients (mean age 66±9.4yrs) hospitalized because of hyponatremia due to diuretics (HCTZ & CT). Twenty for each group (20HCTZ group & 20 CT group). Across all ages, the OR(Odds Ratio) for severe hyponatremia in HCTZ group vs CT group was 10.2 (95% CI: 1.12 -93.35).The OR for hyponatremia in patients of both Groups male vs female was insignificant. The OR for hyponatremia in patients of both sexes older than 65years vs those younger than 65 years was 1.5 (95% CI:0.84- 5.44). In this study we observed , all patients was received combined antihypertensive HCTZ with ARB or CCB , dose of HCTZ was 12.5mg and CT with ARB , dose of CT was 6.25mg. No dose variation was seen in diuretics.Elderly patients are likely to be at particularly high risk. In such cases diuretic use should be associated with close monitoring of sodium levels.
Keyword: Hydrochlorothiazide, Chlorthalidone, hyponatremia, elderly.
