{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:30:11Z","timestamp":1778909411714,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T00:00:00Z","timestamp":1399939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["K23-AG030999"],"award-info":[{"award-number":["K23-AG030999"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["RC1-AG036377"],"award-info":[{"award-number":["RC1-AG036377"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Research Service Award","award":["T32HP19025-07-00"],"award-info":[{"award-number":["T32HP19025-07-00"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To evaluate the risk and predictors of thiazide\u2010induced adverse events (\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      s) in multimorbid older adults in real\u2010world clinical settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National Veterans Affairs data from 2007 to 2008.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Veterans aged 65 and older newly prescribed a thiazide (N\u00a0=\u00a01,060) compared with propensity\u2010matched nonusers of antihypertensive medications (N\u00a0=\u00a01,060).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      The primary outcome was a composite of metabolic AEs defined as sodium less than 135\u00a0mEq\/L, potassium less than 3.5\u00a0mEq\/L, or a decrease in the estimated glomerular filtration rate (e\n                      <jats:styled-content style=\"fixed-case\">GFR<\/jats:styled-content>\n                      ) of more than 25% from the baseline rate. Secondary outcomes included sev\u2010ere AEs (sodium &lt;130\u00a0mEq\/L, potassium &lt;3.0\u00a0mEq\/L, or a decrease in e\n                      <jats:styled-content style=\"fixed-case\">GFR<\/jats:styled-content>\n                      of more than 50%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over 9\u00a0months of follow\u2010up, 14.3% of new thiazide users developed an\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      , compared with 6.0% of nonusers (number needed to harm (\n                      <jats:styled-content style=\"fixed-case\">NNH<\/jats:styled-content>\n                      ) 12, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      )\u00a0=\u00a09\u201317,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001); 1.8% of new users developed a severe\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      , compared with 0.6% of nonusers (\n                      <jats:styled-content style=\"fixed-case\">NNH<\/jats:styled-content>\n                      \u00a0=\u00a082,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.008), and 3.8% of new users had an emergency department visit or hospitalization with an\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      , compared with 2.0% of nonusers (\n                      <jats:styled-content style=\"fixed-case\">NNH<\/jats:styled-content>\n                      \u00a0=\u00a056,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.02). Risk of\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      s did not vary according to age, but having five or more comorbidities was associated with 3.0 times the odds (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.4\u20136.2) of developing an\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      as having one comorbidity (hypertension). Low\u2010normal and unmeasured baseline sodium and potassium values were among the strongest predictors of hyponatremia and hypokalemia, respectively. Only 42% of thiazide users had laboratory monitoring within 90\u00a0days after initiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Thiazide\u2010induced\n                      <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n                      s are common in older adults. Greater attention should be paid to potential complications in prescribing thiazides to older adults, including closer laboratory monitoring before and after initiation of thiazides.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.12839","type":"journal-article","created":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T11:12:03Z","timestamp":1399979523000},"page":"1039-1045","source":"Crossref","is-referenced-by-count":15,"title":["Risk of Thiazide\u2010Induced Metabolic Adverse Events in Older Adults"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7072-9946","authenticated-orcid":false,"given":"Anil N.","family":"Makam","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"John 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