High Blood Pressure Drugs Linked to Metabolic Side Effects

June 27, 2014 — Adults over 65 years old who have recently started taking thiazide diuretics to control high blood pressure are more likely to develop metabolic adverse events, according to a study published this month in the Journal of the American Geriatrics Society.

The study was conducted by the University of Texas Southwestern Medical Center in Dallas. Conclusions were based on data from a 9-month study of over 2,000 veterans, median age 74, who had high blood pressure.

Half of the patients were prescribed a thiazide, a diuretic medication is commonly used to control high blood pressure by reducing the amount of water in the bloodstream, which reduces the total volume and makes it easier for the heart to pump.

Metabolic side effects occurred in 14.3% of individuals on thiazide diuretics, compared to 6% of non-users. These side effects included hypokalemia (low potassium in the bloodstream), hyponatremia (low sodium), and a decrease in kidney function of at least 25%.

Patients on thiazides were also three times as likely to have a severe adverse event (1.8% vs. 0.6%) and nearly twice as likely to require emergency treatment or hospitalization (3.8% vs. 2%).

Researchers recommended that doctors should consider alternative treatments for high-risk patients, such as older adults with multiple health problems:

“Thiazide diuretics undoubtedly reduce cardiovascular morbidity and mortality in older adults with hypertension, but other classes of antihypertensive medications are equally effective in this population and are available at comparable costs in generic formulations.”

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