Common Blood Pressure Medication May Pose Risk to Older Adults

If you're over 65 and taking diuretics for high blood pressure, learn more about the dangers of thiazide diuretiacs.

Adults over 65 who have recently begun thiazide diuretics are at a greater risk for developing metabolic-related adverse events, researchers have found. More than two-thirds of older adults have high blood pressure in the United States and thiazide diuretics are often recommended as the initial medication for these hypertensive patients. While the risks of this medication are well known, the risks are not well quantified in real-world clinical practice, where older adults who are treated may have a number of other illnesses.
Thiazide diuretics primarily inhibit sodium transport in the kidney, leading to urinary loss of sodium and water, which decreases blood pressure
For every 12 adults who were newly prescribed a thiazide diuretic, one developed a metabolic adverse event that he or she would not otherwise have had.

The three metabolic adverse events that researchers assessed were hyponatremia (low sodium levels in the blood), hypokalemia (low potassium levels in the blood), and acute kidney injury (a 25 percent decrease in kidney function from the baseline value before the thiazide diuretic was started).

... researchers were surprised to discover that only 42 percent of older adults who had recently begun taking a thiazide diuretic had laboratory testing to monitor for these adverse events within the first three months of beginning the medication.

"Our research suggests that thiazide-induced adverse events are common in older adults and greater attention should be paid to potential complications in prescribing thiazide diuretics to older adults, including closer laboratory monitoring before and after initiation of thiazides," Dr. Makam said. [emphasis mine]

examples of diuretics

Thiazides diuretics

  • chlorothiazide [(Diuril) (oral or sodium injection)]
  • chlorthalidone (Hygroton)
  • indapamide (Lozol)
  • hydrochlorothiazide (Hydrodiuril)
  • methyclothiazide (Enduron)
  • metolazone (Zaroxolyn, Diulo, Mykrox)
image source

Tags: Thiazides diuretics, serious side effects in seniors

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