Abstract：
Diuretics are commonly used for the treatment of hypertension. Yet, hypokalaemia is a well-recognised adverse effect. We conducted a retrospective study to evaluate the incidence of severe hypokalaemia, defined as requiring hospitalisation, among patients on indapamide.
We searched a territory-wide database, Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority. We traced all hypertensive patients who had been prescribed indapamide in 2007-2016 and all admissions due to hypokalaemia in 2007-2018. Factors associated with hospitalisation were studied using multivariable logistic regression.
During the period studied, 62,881 patients were started on indapamide and 509 (0.8%) were hospitalised for hypokalaemia. 53% of these hospitalisations occurred within the first year of treatment, and half of those in the first year occurred during the first 16 weeks. Female sex (adjusted OR, 1.75; 95%CI, 1.45-2.12) and immediate-release formulation (adjusted OR, 1.41; 95%CI, 1.14-1.75) 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.
In this large population-based study with 147,319 person-years of follow-up, severe hypokalaemia requiring hospitalisation was uncommon among hypertensive patients on indapamide. The risk is higher in women and in the initial weeks and months after starting therapy. The use of the sustained-release formulation reduces 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.
We searched a territory-wide database, Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority. We traced all hypertensive patients who had been prescribed indapamide in 2007-2016 and all admissions due to hypokalaemia in 2007-2018. Factors associated with hospitalisation were studied using multivariable logistic regression.
During the period studied, 62,881 patients were started on indapamide and 509 (0.8%) were hospitalised for hypokalaemia. 53% of these hospitalisations occurred within the first year of treatment, and half of those in the first year occurred during the first 16 weeks. Female sex (adjusted OR, 1.75; 95%CI, 1.45-2.12) and immediate-release formulation (adjusted OR, 1.41; 95%CI, 1.14-1.75) 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.
In this large population-based study with 147,319 person-years of follow-up, severe hypokalaemia requiring hospitalisation was uncommon among hypertensive patients on indapamide. The risk is higher in women and in the initial weeks and months after starting therapy. The use of the sustained-release formulation reduces 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.
摘要：
背景：利尿剂通常用于治疗高血压。然而，低钾血症是公认的不良反应。我们进行了一项回顾性研究，以评估严重低钾血症的发生率，定义为需要住院治疗，在服用吲达帕胺的患者中。
方法：我们搜索了一个地区数据库，香港医院管理局临床资料分析及报告系统。我们追踪了所有在2007-2016年服用过indapamide的高血压患者，以及2007-2018年因低钾血症而入院的所有患者。使用多变量逻辑回归研究与住院相关的因素。
结果：在研究期间，62,881例患者开始接受indapamide治疗，509例（0.8％）因低钾血症住院。这些住院的53%发生在治疗的第一年内，第一年的一半发生在前16周。女性（调整或，1.75；95CI，1.45-2.12）和速释制剂（调整后的OR，1.41；95CI，1.14-1.75）与住院相关。在多变量模型中，高龄并不是一个显著的预测因子。住院期间没有死亡，住院时间中位数为一天。
结论：在这项基于人群的大型研究中，随访了147,319人年，重度低钾血症需要住院治疗的高血压患者并不常见。女性以及开始治疗后的最初几周和几个月的风险更高。缓释制剂的使用降低了风险。我们得出的结论是，使用吲达帕胺治疗高血压是安全的，即使在老年人中，特别是如果使用缓释制剂并定期监测电解质。
方法：我们搜索了一个地区数据库，香港医院管理局临床资料分析及报告系统。我们追踪了所有在2007-2016年服用过indapamide的高血压患者，以及2007-2018年因低钾血症而入院的所有患者。使用多变量逻辑回归研究与住院相关的因素。
结果：在研究期间，62,881例患者开始接受indapamide治疗，509例（0.8％）因低钾血症住院。这些住院的53%发生在治疗的第一年内，第一年的一半发生在前16周。女性（调整或，1.75；95CI，1.45-2.12）和速释制剂（调整后的OR，1.41；95CI，1.14-1.75）与住院相关。在多变量模型中，高龄并不是一个显著的预测因子。住院期间没有死亡，住院时间中位数为一天。
结论：在这项基于人群的大型研究中，随访了147,319人年，重度低钾血症需要住院治疗的高血压患者并不常见。女性以及开始治疗后的最初几周和几个月的风险更高。缓释制剂的使用降低了风险。我们得出的结论是，使用吲达帕胺治疗高血压是安全的，即使在老年人中，特别是如果使用缓释制剂并定期监测电解质。
