Abstract

DYSELECTROLYTEMIA IN COMORBID HYPERTENSIVE PATIENTS ON ANTI-HYPERTENSIVE MEDICATIONS

Dr Sumana Sen*, Dr Madaboina Alekya, Dr Baseera Majid, Dr Nagalla Balakrishna

ABSTRACT

Introduction: Hypertension is commonly associated with co-morbidities like dyslipidemias, stroke, chronic kidney disease, altered glucose profiles and others. Combination of drugs in such situations can influence disruptions in electrolyte homeostasis. Dyselectrolytemia is an important determinant factor for the clinical outcome of patients. Aim: To find out alterations in the serum levels of sodium, potassium, chloride and calcium amongst patients on antihypertensive drugs along with certain co-morbid conditions. Our secondary objective was to look into the bicarbonate levels along with aforesaid electrolyte abnormalities in the patients admitted at intensive care unit (ICU). Methods: Retrospective observational study wherein data collection was done by means of interpolating patients records by manual extraction and aggregation from files stored at the medical records department. The data included patients with hypertension and accompanying co- morbidities who were on a variety of antihypertensive medications, some of whom required intensive care unit (ICU) stay as well. Statistical methods were used for analysis of data. Results: Prevalance of hypokalemia was found to be higher in females compared to males (p-value:0.033).44.6% and 42.9% of ICU patients had statistically significant hypochloremia (p-value:0.002) and hypocalcemia(p-value:0.007) respectively in comparision with non-ICU patients. Independent association between DM type 2 with hyponatremia (p-value:0.02) and hypochloremia(p-value:0.037) have been found. Similar associations between CVA and hypocalcemia (p-value:0.001); CKD/AKI and hypokalemia (p-value:0.004) have been noticed. Prevalance of hypocalcemia was significantly more in non-diabetics than diabetics (p-value:0.029). Serum chloride levels were directly related to serum sodium (p-value:0.00), serum potassium(p-value:0.002), and inversely related to serum bicarbonate(p-value:0.040) levels. Conclusion: Electrolyte imbalances are associated with several variables, amongst which statistically significant prevalence was higher in ICU and co-morbid hypertensive patients on antihypertensive drugs. There was no significant association between dyselectrolytemia and anti-hypertensive drugs in this study. Hence one should not be deterred to prescribe anti-hypertensive drugs but be vigilant in elderly and co-morbid patients.

Keywords: Dyselectrolytemia, antihypertensive drugs, hypertension, co-morbidity.