Key result
Combination therapy with an angiotensin II receptor blocker and a thiazide diuretic produced severe hyponatremia (serum sodium ≤116 mmol/L) in three elderly hypertensive patients, which resolved upon discontinuation.
Why the study?
Does combination therapy with an ARB and a thiazide diuretic cause severe hyponatremia in elderly hypertensive patients?
Case Report (n=3)
No
Does combination therapy with an ARB and a thiazide diuretic cause severe hyponatremia in elderly hypertensive patients?
Combination therapy with ARBs and thiazide diuretics can cause severe, potentially life-threatening hyponatremia in elderly hypertensive patients, necessitating careful monitoring of serum sodium levels.
Answers are grounded in this paper and cite their sources.
May signal risk of severe hyponatremia with ARB-thiazide combos in elderly; hypothesis-generating case report requiring confirmation.
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.
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Yamada et al. (2014) conducted a case report in Hypertension and severe hyponatremia (n=3). Combination therapy of Angiotensin II Receptor Blocker and Thiazide was evaluated on Serum sodium level. Combination therapy with an angiotensin II receptor blocker and a thiazide diuretic produced severe hyponatremia (serum sodium ≤116 mmol/L) in three elderly hypertensive patients, which resolved upon discontinuation.
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