{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:26:59Z","timestamp":1780986419494,"version":"3.54.1"},"reference-count":27,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n<jats:title>Background &amp; Objectives<\/jats:title>\n<jats:p>Although thiazide diuretics are frequently used to treat hypertension, they may also raise the risk of syncope and falls. The purpose of this study was to look at the relationship between hypertension individuals\u2019 use of thiazide diuretics and falls or syncope.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective cohort study, conducted between March 2019 and March 2024, included 236 individuals with hypertension taking thiazides and 236 controls not taking thiazides. Data from electronic medical records were extracted, including demographic, clinical, laboratory, and outcome data. The main outcome was the occurrence of syncope episodes or falls. Logistic regression analyses examined associations between various factors and falls\/syncope risk.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The study included 236 study participants taking thiazides (118 men, 118 women) and 236 controls not taking thiazides (118 men, 118 women). Study participants taking thiazides had a\u00a0higher prevalence of hyponatremia (57 study participants, 24.1% <jats:italic>vs<\/jats:italic>. 31 study participants, 13.1%), hypokalaemia (52 study participants, 22% <jats:italic>vs<\/jats:italic>. 32 study participants, 13.6%), hypercalcemia (37 study participants, 15.7% <jats:italic>vs<\/jats:italic>. 17 study participants, 7.2%), metabolic alkalosis (89 study participants, 37.7% <jats:italic>vs<\/jats:italic>. 52 study participants, 22%), acute kidney injury (59 study participants, 25% <jats:italic>vs<\/jats:italic>. 30 study participants, 12.7%), and chronic kidney disease (89 study participants, 37.7% <jats:italic>vs<\/jats:italic>. 59 study participants, 25%) compared to controls (all <jats:italic>P<\/jats:italic>&lt;0.05). The prevalence of falls\/syncope events was significantly higher in the thiazide group (76 study participants, 32.2%) compared to the non-thiazide group (46 study participants, 19.5%), with a <jats:italic>P<\/jats:italic> value of 0.002. Multivariate analysis showed increased falls\/syncope risk with age [adjusted odds ratio (AOR)=1.38], congestive heart failure (AOR=2.12), longer thiazide duration (AOR=1.21), hyponatremia (AOR=1.68), hypokalaemia (AOR=1.72), metabolic alkalosis (AOR=1.68), acute kidney injury (AOR=1.85), and decreased eGFR (AOR=1.22 per 10 ml\/min\/1.73m<jats:sup>2<\/jats:sup> decrease).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Interpretation &amp; Conclusion<\/jats:title>\n<jats:p>Thiazide diuretic use in hypertensive patients is related to syncope, potentially mediated by electrolyte disturbances and renal impairment. These results highlight the importance of careful monitoring and individualized treatment approaches when prescribing thiazide diuretics to hypertensive patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijmr_638_2024","type":"journal-article","created":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T11:35:02Z","timestamp":1739619302000},"page":"99-106","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Thiazide diuretics use &amp; risk of falls &amp; syncope among hypertensives: A retrospective cohort study"],"prefix":"10.25259","volume":"161","author":[{"given":"M.","family":"Yogesh","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohil","family":"Karangia","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Shri M P Shah Government Medical College, Jamnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Nagda","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freya","family":"Kankhara","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Shri M P Shah Government Medical College, Jamnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parth Anilbhai","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandan","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Narendra Modi Medical College, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"key":"10.25259\/IJMR_638_2024\/ref-1","first-page":"1","article-title":"Hypertension prevalence among adults aged 18 and over: United States, 2017-2018","volume":"364","author":"Ostchega","year":"2020","journal-title":"NCHS Data Brief"},{"key":"10.25259\/IJMR_638_2024\/ref-2","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.25259\/IJMR_638_2024\/ref-3","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1007\/s00198-012-2053-3","article-title":"Diuretic initiation and the acute risk of hip fracture","volume":"24","author":"Berry","year":"2013","journal-title":"Osteoporos Int"},{"key":"10.25259\/IJMR_638_2024\/ref-4","article-title":"Thiazide Diuretics","volume-title":"StatPearls","author":"Akbari","year":"2025"},{"key":"10.25259\/IJMR_638_2024\/ref-5","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.1056\/NEJM198812293192604","article-title":"Risk factors for falls among elderly persons living in the community","volume":"319","author":"Tinetti","year":"1988","journal-title":"N Engl J Med"},{"key":"10.25259\/IJMR_638_2024\/ref-6","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1053\/j.ajkd.2019.07.011","article-title":"Thiazide-associated hyponatremia: Clinical manifestations and pathophysiology","volume":"75","author":"Filippone","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"10.25259\/IJMR_638_2024\/ref-7","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jash.2007.07.004","article-title":"Metabolic complications associated with use of thiazide diuretics","volume":"1","author":"Palmer","year":"2007","journal-title":"J Am Soc Hypertens"},{"key":"10.25259\/IJMR_638_2024\/ref-8","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.gerinurse.2023.05.009","article-title":"The association between diuretics and falls in older adults: A systematic review and meta-analysis","volume":"52","author":"Bai","year":"2023","journal-title":"Geriatr Nurs"},{"key":"10.25259\/IJMR_638_2024\/ref-9","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s41999-023-00752-7","article-title":"Diuretics, SGLT2 inhibitors and falls in older heart failure patients: To prescribe or to deprescribe? 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