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Associations Between Antihypertensive Medications and Severe Hyponatremia: A Swedish Population–Based Case–Control Study
- Source :
- The Journal of Clinical Endocrinology and Metabolism
- Publication Year :
- 2020
- Publisher :
- The Endocrine Society, 2020.
-
Abstract
- BackgroundCalcium channel blockers (CCBs), beta-receptor blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin II receptor blockers (ARBs) have occasionally been reported to cause severe hyponatremia. The aim was to explore the association between CCBs, BBs, ACEIs, and ARBs and hospitalization due to hyponatremia.MethodsPatients hospitalized with a principal diagnosis of hyponatremia (n = 11 213) were compared with matched controls (n = 44 801). Linkage of national population-based registers was used to acquire data. Multivariable logistic regression adjusting for co-medications, diseases, previous hospitalizations, and socioeconomic factors was used to explore the association between hospitalization for severe hyponatremia and the use of different CCBs, BBs, ACEIs, and ARBs. Furthermore, newly initiated (≤90 days) and ongoing use were examined separately.ResultsAdjusted odds ratios (aORs) (95% confidence interval) for the investigated 4 drug classes ranged from 0.86 (0.81-0.92) for CCBs to 1.15 (1.07-1.23) for ARBs. For newly initiated drugs, aORs spanned from 1.64 (1.35-1.98) for CCBs to 2.24 (1.87-2.68) for ACEIs. In contrast, the corresponding associations for ongoing therapy were not elevated, ranging from 0.81 (0.75-0.86) for CCBs to 1.08 (1.00-1.16) for ARBs. In the CCBs subgroups, aOR for newly initiated vascular CCBs was 1.95 (1.62-2.34) whereas aOR for ongoing treatment was 0.82 (0.77-0.88).ConclusionsFor newly initiated CCBs, BBs, ACEIs, and ARBs, the risk of hospitalization due to hyponatremia was moderately elevated. In contrast, there was no evidence that ongoing treatment with investigated antihypertensive drugs increased the risk for hospitalization due to hyponatremia.
- Subjects :
- Drug
medicine.medical_specialty
hyponatremia
Endocrinology, Diabetes and Metabolism
media_common.quotation_subject
Clinical Biochemistry
Population
adverse reaction
030204 cardiovascular system & hematology
Logistic regression
Biochemistry
03 medical and health sciences
angiotensin converting enzyme inhibitors
0302 clinical medicine
Endocrinology
Internal medicine
Medicine
cardiovascular diseases
030212 general & internal medicine
Adverse effect
education
Clinical Research Articles
beta-receptor blockers
media_common
calcium channel blockers
education.field_of_study
angiotensin II receptor blockers
business.industry
Biochemistry (medical)
SIADH
Case-control study
Odds ratio
medicine.disease
Confidence interval
business
Hyponatremia
AcademicSubjects/MED00250
hospitalization
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....698ff89f474f1fd73185cc25d931934c