Combination therapy of angiotensin II receptor blocker and thiazide produces severe hyponatremia in elderly hypertensive subjects.
Thiazide diuretics are known to produce severe hyponatremia as well as hypokalemia. The present study demonstrated severe hyponatremia in three hypertensive patients who had received combination therapy consisting of an angiotensin II receptor blocker (ARB) and thiazide. The serum sodium (Na) levels in all three cases were markedly reduced to below 116 mmol/L, and the patients exhibited augmented urinary excretion of Na with a reduced circulatory blood volume. After withdrawing the ARB and thiazide treatment, the serum Na levels normalized within one to two weeks. Combination therapy with ARBs and thiazide may cause hyponatremia in elderly patients.
Division of Endocrinology and Metabolism, Saitama Medical Center, Jichi Medical University, Japan.
Hodaka
H
Yamada
Tomoko
T
Asano
Atsushi
A
Aoki
Aki
A
Ikoma
Masashi
M
Yoshida
Ikuyo
I
Kusaka
Masanobu
M
Kawakami
Masafumi
M
Kakei
San-e
SE
Ishikawa
D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced*; D008297:Male; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood / Q000652:urine; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D049993:Sodium Chloride Symporter Inhibitors; D012964:Sodium