| Diuretic therapy for hypertension and the risk of primary cardiac arrest. | |
| | |
MedLine Citation:
|
PMID: 8196728 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The results of trials of the primary prevention of coronary heart disease have suggested that treating hypertension with high doses of thiazide diuretic drugs might increase the risk of sudden death from cardiac causes. In contrast, treatment with low doses of thiazide reduces the risk of coronary heart disease. METHODS: To examine the association between thiazide treatment for hypertension and the occurrence of primary cardiac arrest, we conducted a population-based case-control study among enrollees of a health maintenance organization. The case patients were 114 persons with hypertension who had a primary cardiac arrest from 1977 through 1990. The control patients were a stratified random sample of 535 persons with hypertension. The patients' treatment was assessed with the use of a computerized pharmacy data base. Records of their ambulatory care were reviewed to determine other clinical characteristics. RESULTS: The risk of primary cardiac arrest among patients receiving combined thiazide and potassium-sparing diuretic therapy was lower than that among patients treated with a thiazide without potassium-sparing therapy (odds ratio, 0.3; 95 percent confidence interval, 0.1 to 0.7). As compared with low-dose thiazide therapy (25 mg daily), moderate-dose therapy (50 mg daily) was associated with a moderate increase in risk (odds ratio, 1.7; 95 percent confidence interval, 0.7 to 4.5), and high-dose therapy (100 mg daily) was associated with a larger increase in risk (odds ratio, 3.6; 95 percent confidence interval, 1.2 to 10.8) (P value for trend, 0.02). The addition of a potassium-sparing drug to low-dose thiazide therapy was associated with a reduced risk of cardiac arrest (odds ratio, 0.4; 95 percent confidence interval, 0.1 to 1.5). CONCLUSIONS: Both the dose of thiazide drugs and the addition of potassium-sparing drugs influence the risk of primary cardiac arrest. These results may explain the differences in the effect of antihypertensive therapy on mortality from coronary heart disease in previous clinical trials. |
| | |
Authors:
|
D S Siscovick; T E Raghunathan; B M Psaty; T D Koepsell; K G Wicklund; X Lin; L Cobb; P M Rautaharju; M K Copass; E H Wagner |
Related Documents
:
|
7838188 - Developmental and neurologic status of children after heart surgery with hypothermic ci... 17241498 - Post-resuscitation haemodynamics in a novel acute myocardial infarction cardiac arrest ... 2802288 - Cpr-dependent consciousness: evidence for cardiac compression causing forward flow. 14625108 - Vf recurrence: characteristics and patient outcome in out-of-hospital cardiac arrest. 17291348 - St segment depression: the possible role of global repolarization dynamics. 17670338 - Native aortic valve thrombosis: a rare cause of acute ischemia of the lower limb. |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: The New England journal of medicine Volume: 330 ISSN: 0028-4793 ISO Abbreviation: N. Engl. J. Med. Publication Date: 1994 Jun |
Date Detail:
|
Created Date: 1994-06-30 Completed Date: 1994-06-30 Revised Date: 2010-03-24 |
Medline Journal Info:
|
Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1852-7 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, University of Washington, Seattle. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Benzothiadiazines* Case-Control Studies Confidence Intervals Death, Sudden, Cardiac / etiology Diuretics Female Heart Arrest / chemically induced*, epidemiology Humans Hypertension / drug therapy* Male Middle Aged Odds Ratio Potassium / administration & dosage Regression Analysis Risk Sodium Chloride Symporter Inhibitors / administration & dosage, adverse effects*, therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
|
HL42456-03/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Benzothiadiazines; 0/Diuretics; 0/Sodium Chloride Symporter Inhibitors; 7440-09-7/Potassium |
| Comments/Corrections | |
Comment In:
|
N Engl J Med. 1994 Jun 30;330(26):1899-900
[PMID:
8196736
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Low-dose cyclosporine for the treatment of Crohn's disease. The Canadian Crohn's Relapse Prevention ...
Next Document: A decision analysis of streptokinase plus heparin as compared with heparin alone for deep-vein throm...