{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:25:55Z","timestamp":1790115955640,"version":"4.0.1"},"reference-count":42,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cebix incorporated","award":["CBX129801-DN-201"],"award-info":[{"award-number":["CBX129801-DN-201"]}]},{"name":"Stockholm County Medical Committee","award":["HSTV18048"],"award-info":[{"award-number":["HSTV18048"]}]},{"DOI":"10.13039\/501100006285","name":"Magnus Bergvall Foundation","doi-asserted-by":"publisher","award":["2017-02138"],"award-info":[{"award-number":["2017-02138"]}],"id":[{"id":"10.13039\/501100006285","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006285","name":"Magnus Bergvall Foundation","doi-asserted-by":"publisher","award":["2018-02566"],"award-info":[{"award-number":["2018-02566"]}],"id":[{"id":"10.13039\/501100006285","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009766","name":"County Council of V\u00e4rmland","doi-asserted-by":"publisher","award":["930575"],"award-info":[{"award-number":["930575"]}],"id":[{"id":"10.13039\/501100009766","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Calcium channel blockers (CCBs), beta-receptor blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin II receptor blockers (ARBs) have occasionally been reported to cause severe hyponatremia. The aim was to explore the association between CCBs, BBs, ACEIs, and ARBs and hospitalization due to hyponatremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients hospitalized with a principal diagnosis of hyponatremia (n = 11 213) were compared with matched controls (n = 44 801). Linkage of national population-based registers was used to acquire data. Multivariable logistic regression adjusting for co-medications, diseases, previous hospitalizations, and socioeconomic factors was used to explore the association between hospitalization for severe hyponatremia and the use of different CCBs, BBs, ACEIs, and ARBs. Furthermore, newly initiated (\u226490 days) and ongoing use were examined separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adjusted odds ratios (aORs) (95% confidence interval) for the investigated 4 drug classes ranged from 0.86 (0.81-0.92) for CCBs to 1.15 (1.07-1.23) for ARBs. For newly initiated drugs, aORs spanned from 1.64 (1.35-1.98) for CCBs to 2.24 (1.87-2.68) for ACEIs. In contrast, the corresponding associations for ongoing therapy were not elevated, ranging from 0.81 (0.75-0.86) for CCBs to 1.08 (1.00-1.16) for ARBs. In the CCBs subgroups, aOR for newly initiated vascular CCBs was 1.95 (1.62-2.34) whereas aOR for ongoing treatment was 0.82 (0.77-0.88).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For newly initiated CCBs, BBs, ACEIs, and ARBs, the risk of hospitalization due to hyponatremia was moderately elevated. In contrast, there was no evidence that ongoing treatment with investigated antihypertensive drugs increased the risk for hospitalization due to hyponatremia.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgaa194","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T05:06:16Z","timestamp":1586840776000},"page":"e3696-e3705","source":"Crossref","is-referenced-by-count":33,"title":["Associations Between Antihypertensive Medications and Severe Hyponatremia: A Swedish Population\u2013Based Case\u2013Control Study"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-6987","authenticated-orcid":false,"given":"Henrik","family":"Falhammar","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Skov","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Medicine, Karlstad Central Hospital, Karlstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Calissendorff","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nathanson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonatan D","family":"Lindh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buster","family":"Mannheimer","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"issue":"7 Suppl 1","key":"2021122105422193500_CIT0001","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.amjmed.2006.05.005","article-title":"Incidence and prevalence of hyponatremia","volume":"119","author":"Upadhyay","year":"2006","journal-title":"Am J Med."},{"key":"2021122105422193500_CIT0002","doi-asserted-by":"crossref","first-page":"9041694","DOI":"10.1155\/2018\/9041694","article-title":"Magnesium and human health: perspectives and research directions","volume":"2018","author":"Al Alawi","year":"2018","journal-title":"Int J Endocrinol."},{"issue":"1","key":"2021122105422193500_CIT0003","doi-asserted-by":"crossref","first-page":"71.e1","DOI":"10.1016\/j.amjmed.2005.09.026","article-title":"Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits","volume":"119","author":"Renneboog","year":"2006","journal-title":"Am J Med."},{"issue":"3","key":"2021122105422193500_CIT0004","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/jgs.13325","article-title":"Symptoms and characteristics of individuals with profound hyponatremia: a prospective multicenter observational study","volume":"63","author":"Nigro","year":"2015","journal-title":"J Am Geriatr Soc."},{"issue":"10 Suppl 1","key":"2021122105422193500_CIT0005","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.amjmed.2013.07.006","article-title":"Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations","volume":"126","author":"Verbalis","year":"2013","journal-title":"Am J Med."},{"issue":"3","key":"2021122105422193500_CIT0006","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-13-1020","article-title":"Clinical practice guideline on diagnosis and treatment of hyponatraemia","volume":"170","author":"Spasovski","year":"2014","journal-title":"Eur J Endocrinol."},{"issue":"3","key":"2021122105422193500_CIT0007","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/s12020-019-02073-x","article-title":"Sex-specific risks of death in patients hospitalized for hyponatremia: a population-based study","volume":"66","author":"Mannheimer","year":"2019","journal-title":"Endocrine."},{"issue":"1","key":"2021122105422193500_CIT0008","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1053\/j.ajkd.2008.03.004","article-title":"A review of drug-induced hyponatremia","volume":"52","author":"Liamis","year":"2008","journal-title":"Am J Kidney Dis."},{"key":"2021122105422193500_CIT0009","doi-asserted-by":"crossref","first-page":"d4551","DOI":"10.1136\/bmj.d4551","article-title":"Antidepressant use and risk of adverse outcomes in older people: population based cohort study","volume":"343","author":"Coupland","year":"2011","journal-title":"BMJ."},{"issue":"5","key":"2021122105422193500_CIT0010","doi-asserted-by":"crossref","first-page":"e011200","DOI":"10.1136\/bmjopen-2016-011200","article-title":"Antidepressants and the risk of hyponatremia: a Danish register-based population study","volume":"6","author":"Leth-M\u00f8ller","year":"2016","journal-title":"BMJ Open."},{"issue":"1","key":"2021122105422193500_CIT0011","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.amjmed.2017.07.025","article-title":"Differences in associations of antidepressants and hospitalization due to hyponatremia","volume":"131","author":"Farmand","year":"2018","journal-title":"Am J Med."},{"key":"2021122105422193500_CIT0012","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.seizure.2018.04.025","article-title":"Differences in associations of antiepileptic drugs and hospitalization due to hyponatremia: a population-based case-control study","volume":"59","author":"Falhammar","year":"2018","journal-title":"Seizure."},{"key":"2021122105422193500_CIT0013","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ejim.2018.08.012","article-title":"Associations of proton pump inhibitors and hospitalization due to hyponatremia: a population-based case-control study","volume":"59","author":"Falhammar","year":"2019","journal-title":"Eur J Intern Med."},{"key":"2021122105422193500_CIT0014","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ejim.2018.11.011","article-title":"Antipsychotics and severe hyponatremia: a Swedish population-based case-control study","volume":"60","author":"Falhammar","year":"2019","journal-title":"Eur J Intern Med."},{"key":"2021122105422193500_CIT0015","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ejim.2019.08.006","article-title":"Tramadol- and codeine-induced severe hyponatremia: a Swedish population-based case-control study","volume":"69","author":"Falhammar","year":"2019","journal-title":"Eur J Intern Med."},{"issue":"1","key":"2021122105422193500_CIT0016","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/pds.4922","article-title":"Factors of importance for discontinuation of thiazides associated with hyponatremia in Sweden: A population-based register study","volume":"29","author":"Fahl\u00e9n Bergh","year":"2020","journal-title":"Pharmacoepidemiol Drug Saf."},{"issue":"10","key":"2021122105422193500_CIT0017","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J Hypertens."},{"issue":"9","key":"2021122105422193500_CIT0018","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jama.2013.184182","article-title":"Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries","volume":"310","author":"Chow","year":"2013","journal-title":"JAMA."},{"issue":"9","key":"2021122105422193500_CIT0019","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1001\/archinte.1995.00430090099011","article-title":"Risk factors for the development of hyponatremia in psychiatric inpatients","volume":"155","author":"Siegler","year":"1995","journal-title":"Arch Intern Med."},{"issue":"2","key":"2021122105422193500_CIT0020","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1023\/A:1007708831545","article-title":"Hyponatremia and amlodipine therapy","volume":"13","author":"Malaterre","year":"1999","journal-title":"Cardiovasc Drugs Ther."},{"key":"2021122105422193500_CIT0021","doi-asserted-by":"crossref","DOI":"10.1002\/cpt.1562","article-title":"Severe hyponatremia is often drug induced: 10-year results of a prospective pharmacovigilance program","author":"Ramirez","year":"2019;106(6):1362-1379","journal-title":"Clin Pharmacol Ther."},{"issue":"3","key":"2021122105422193500_CIT0022","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.archger.2014.08.002","article-title":"Severe hyponatremia in older patients at admission in an internal medicine department","volume":"59","author":"Correia","year":"2014","journal-title":"Arch Gerontol Geriatr."},{"issue":"6","key":"2021122105422193500_CIT0023","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1067\/mcp.2002.124520","article-title":"Angiotensin-converting enzyme inhibitor-induced syndrome of inappropriate secretion of antidiuretic hormone: case report and review of the literature","volume":"71","author":"Izzedine","year":"2002","journal-title":"Clin Pharmacol Ther."},{"issue":"1","key":"2021122105422193500_CIT0024","doi-asserted-by":"crossref","first-page":"1470320319834409","DOI":"10.1177\/1470320319834409","article-title":"Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor therapy in the perioperative period","volume":"20","author":"Nakayama","year":"2019","journal-title":"J Renin Angiotensin Aldosterone Syst."},{"key":"2021122105422193500_CIT0025","doi-asserted-by":"crossref","DOI":"10.1136\/bcr.06.2009.1932","article-title":"Severe hyponatraemia during therapy with ramipril","volume":"2009","author":"Ramasamy","year":"2009","journal-title":"BMJ Case Rep."},{"issue":"4","key":"2021122105422193500_CIT0026","doi-asserted-by":"crossref","first-page":"219","DOI":"10.4103\/0976-500X.171880","article-title":"A case of losartan-induced severe hyponatremia","volume":"6","author":"Das","year":"2015","journal-title":"J Pharmacol Pharmacother."},{"issue":"9","key":"2021122105422193500_CIT0027","doi-asserted-by":"crossref","first-page":"3520","DOI":"10.1210\/JC.2015-2093","article-title":"Increased cardiovascular and metabolic morbidity in patients with 21-hydroxylase deficiency: a Swedish population-based national cohort study","volume":"100","author":"Falhammar","year":"2015","journal-title":"J Clin Endocrinol Metab."},{"issue":"3","key":"2021122105422193500_CIT0028","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s12020-019-02160-z","article-title":"Inverse association between glucose-lowering medications and severe hyponatremia: a Swedish population-based case-control study","volume":"67","author":"Falhammar","year":"2020","journal-title":"Endocrine."},{"key":"2021122105422193500_CIT0029","article-title":"Data from: associations between antihypertensive medications and severe hyponatremia: a Swedish population\u2013based case\u2013control study","author":"Falhammar","journal-title":"Figshare."},{"issue":"7","key":"2021122105422193500_CIT0030","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1002\/pds.1294","article-title":"The new Swedish Prescribed Drug Register: opportunities for pharmacoepidemiological research and experience from the first six months","volume":"16","author":"Wettermark","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf."},{"issue":"11","key":"2021122105422193500_CIT0031","doi-asserted-by":"crossref","first-page":"4191","DOI":"10.1210\/jc.2017-01139","article-title":"Reduced frequency of biological and increased frequency of adopted children in males with 21-hydroxylase deficiency: a Swedish population-based national cohort study","volume":"102","author":"Falhammar","year":"2017","journal-title":"J Clin Endocrinol Metab."},{"key":"2021122105422193500_CIT0032"},{"issue":"6","key":"2021122105422193500_CIT0033","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/j.1751-7176.2008.08126.x","article-title":"The silent epidemic of thiazide-induced hyponatremia","volume":"10","author":"Mann","year":"2008","journal-title":"J Clin Hypertens (Greenwich)."},{"key":"2021122105422193500_CIT0034","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1097\/00005344-198507004-00007","article-title":"Natriuretic effect of calcium antagonists","volume":"7","author":"Zanchetti","year":"1985","journal-title":"J Cardiovasc Pharmacol."},{"issue":"17","key":"2021122105422193500_CIT0035","doi-asserted-by":"crossref","first-page":"10I","DOI":"10.1016\/0002-9149(89)90956-9","article-title":"Pharmacologic profile of amlodipine","volume":"64","author":"Burges","year":"1989","journal-title":"Am J Cardiol."},{"issue":"3","key":"2021122105422193500_CIT0036","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1152\/physrev.1998.78.3.583","article-title":"Angiotensin, thirst, and sodium appetite","volume":"78","author":"Fitzsimons","year":"1998","journal-title":"Physiol Rev."},{"issue":"1","key":"2021122105422193500_CIT0037","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0306-4522(95)00238-E","article-title":"The association of thirst, sodium appetite and vasopressin release with c-fos expression in the forebrain of the rat after intracerebroventricular injection of angiotensin II, angiotensin-(1-7) or carbachol","volume":"69","author":"Mahon","year":"1995","journal-title":"Neuroscience."},{"issue":"9","key":"2021122105422193500_CIT0038","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1177\/0960327110387455","article-title":"Losartan potassium\/hydrochlorothiazide (Preminent\u00ae) and hyponatremia: case series of 40 patients","volume":"30","author":"Kinoshita","year":"2011","journal-title":"Hum Exp Toxicol."},{"issue":"2","key":"2021122105422193500_CIT0039","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ejim.2012.10.014","article-title":"Epidemiology and characteristics of hyponatremia in the emergency department","volume":"24","author":"Olsson","year":"2013","journal-title":"Eur J Intern Med."},{"issue":"5","key":"2021122105422193500_CIT0040","doi-asserted-by":"crossref","first-page":"537.e9","DOI":"10.1016\/j.amjmed.2015.11.005","article-title":"Diagnosing and treating the syndrome of inappropriate antidiuretic hormone secretion","volume":"129","author":"Verbalis","year":"2016","journal-title":"Am J Med."},{"issue":"Suppl 1","key":"2021122105422193500_CIT0041","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.4103\/0976-500X.120942","article-title":"Pharmacovigilance in Italy: an overview","volume":"4","author":"Mazzitello","year":"2013","journal-title":"J Pharmacol Pharmacother."},{"key":"2021122105422193500_CIT0042","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.ijcard.2015.10.002","article-title":"The importance of Pharmacovigilance for the drug safety: focus on cardiovascular profile of incretin-based therapy","volume":"202","author":"Sportiello","year":"2016","journal-title":"Int J Cardiol."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa194\/33565246\/dgaa194.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/10\/e3696\/41828232\/dgaa194.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/10\/e3696\/41828232\/dgaa194.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T05:50:04Z","timestamp":1666331404000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/105\/10\/e3696\/5819729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,14]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,4,14]]},"published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa194","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,4,14]]}}}