Changes in serum potassium mediate thiazide-induced diabetes

Tariq Shafi, Lawrence Appel, Edgar R Miller, Michael John Klag, Rulan S. Parekh

Research output: Contribution to journalArticle

Abstract

Thiazides, recommended as first-line antihypertensive therapy, are associated with an increased risk of diabetes. Thiazides also lower serum potassium. To determine whether thiazide-induced diabetes is mediated by changes in potassium, we analyzed data from 3790 nondiabetic participants in the Systolic Hypertension in Elderly Program, a randomized clinical trial of isolated systolic hypertension in individuals aged ≥60 years treated with chlorthalidone or placebo. Incident diabetes was defined by self-report, antidiabetic medication use, fasting glucose ≥126 mg/dL, or random glucose ≥200 mg/dL. The mediating variable was change in serum potassium during year 1. Of the 459 incident cases of diabetes during follow-up, 42% occurred during year 1. In year 1, the unadjusted incidence rates of diabetes per 100 person-years were 6.1 and 3.0 in the chlorthalidone and placebo groups, respectively. In year 1, the adjusted diabetes risk (hazard ratio) with chlorthalidone was 2.07 (95% CI: 1.51 to 2.83; P

Original languageEnglish (US)
Pages (from-to)1022-1029
Number of pages8
JournalHypertension
Volume52
Issue number6
DOIs
StatePublished - Dec 2008

Fingerprint

Chlorthalidone
Thiazides
Potassium
Serum
Placebos
Hypertension
Glucose
Hypoglycemic Agents
Self Report
Antihypertensive Agents
Fasting
Randomized Controlled Trials
Odds Ratio
Incidence
Therapeutics

Keywords

  • Chlorthalidone
  • Diabetes mellitus
  • Hypertension
  • Hypokalemia
  • Potassium
  • Thiazide diuretics

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Changes in serum potassium mediate thiazide-induced diabetes. / Shafi, Tariq; Appel, Lawrence; Miller, Edgar R; Klag, Michael John; Parekh, Rulan S.

In: Hypertension, Vol. 52, No. 6, 12.2008, p. 1022-1029.

Research output: Contribution to journalArticle

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