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Adverse effect profile of trichlormethiazide: a retrospective observational study Full Text
Cardiovascular Diabetology, 06/02/2011
Clinical Article
Takahashi Y et al. – This study showed adverse effects of decreased serum potassium and increased serum uric acid with trichlormethiazide treatment, and suggested that a lower dose of trichlormethiazide may minimize these adverse effects. These findings support the current trend in hypertension therapeutics to shift towards lower doses of thiazides.
Methods- Authors used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and July 31, 2010, to identify cohorts of new trichlormethiazide users (n=99 for 1 mg, n=61 for 2 mg daily dosage) and an equal number of non–users (control).
- Authors used propensity–score matching to adjust for differences between users and control for each dosage, and compared serum chemical data including serum sodium, potassium, uric acid, creatinine and urea nitrogen.
- The mean exposure of trichlormethiazide of 1 mg and 2 mg users was 58 days and 64 days, respectively.
- The mean age was 66 years, and 55% of trichlormethiazide users of the 1 mg dose were female.
- In trichlormethiazide users of the 2 mg dose, the mean age was 68 years, and 43% of users were female.
- There were no statistically significant differences in all covariates (age, sex, comorbid diseases, past drugs, and current antihypertensive drugs) between trichlormethiazide users and controls for both doses.
- In trichlormethiazide users of the 2 mg dose, the reduction of serum potassium level and the elevation of serum uric acid level were significant compared with control, whereas changes of mean serum sodium, creatinine and urea nitrogen levels were not significant.
- In trichlormethiazide users of the 1 mg dose, all tests showed no statistically significant change from baseline to during the exposure period in comparison with control.
