Proportion of patients taking indapamide developing severe hypokalaemia. (14th October 2021)

• Record Type: Journal Article
• Authors: Lin, Z; Tang, V; Tsoi, M F; Cheung, B M Y
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Pharmacotherapy; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.2366
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Introduction: Diuretics are commonly used for the treatment of hypertension. Yet, hypokalaemia is a well-recognized adverse effect. Purpose: To evaluate the proportion of patients taking indapamide who developed severe hypokalaemia, defined as requiring hospitalisation. Indapamide was by far the most commonly used diuretic for hypertension in Hong Kong. Methods: We searched the Hong Kong Hospital Authority Clinical Data Analysis and Reporting System, which is a territory-wide database of computerised medical records. All hypertensive patients prescribed indapamide monotherapy in 2007–2016 and all admissions due to hypokalaemia in 2007–2018 were traced. Factors associated with hospitalisation were studied using multivariable logistic regression. Results: During the study period, 62, 881 patients were started on indapamide and 509 (0.81%) were hospitalised for hypokalaemia. 59% of these hospitalisations occurred within 16 weeks. Female sex (OR = 1.73; 95% CI, 1.43–2.09) and immediate-release formulation (OR = 1.44; 95% CI, 1.16–1.78) were associated with hospitalisation. In the multivariable model, advanced age was not a significant predictor. There were no deaths during hospitalisation and the median length of hospital stay was one day. Conclusions: In this large population-based study with 147614 person-years of follow-up, severe hypokalaemia requiring hospitalisation was uncommon among hypertensive patients on indapamide. Half of these occurred during the first 16 weeks. Female sex and the immediate release formulation increased the risk. We conclude that using indapamide to treat hypertension is safe, even in the elderly, especially if the sustained release formulation is used and electrolytes are monitored periodically. FUNDunding Acknowledgement: Type of funding sources: None.