European Journal of Cardiovascular Medicine

Background: Thiazides are used commonly to manage hypertension and can also increase the risk of falls and syncope in its users. However, this issue remains under studied and mentioned. Aim: The present study was aimed to assess the relationship between thiazide use and syncope or fall in hypertensive Indian subjects admitted to the tertiary care hospital Methods: The present study assessed 472 subjects that presented with hypertension to the Institute within the defined study period and were on thiazides and 472 control subjects that were not on thiazides. The data from all the subjects were gathered and assessed from the previous records of the Institute including demographic characteristics, clinical data, laboratory findings, and outcomes. The main outcome assessed was syncope or fall episode occurrence. Also, association in syncope/fall risk and various factors was assessed.  Results: The study results showed higher prevalence of chronic kidney disease, acute kidney injury, metabolic alkalosis, hypercalcemia, hypokalaemia, and hyponatremia in subjects with thiazides compared to control subjects with p-value of <0.05. Also, a significantly higher prevalence of syncope and fall was seen in subjects on thiazides compared to controls with p=0.002. Also, increased risk of syncope/ fall was seen in subjects with decreased eGFR, acute kidney injury, metabolic alkalosis, hypokalaemia, hyponatremia, longer thiazide duration, congestive heart failure, and age. Conclusion: The use of thiazide diuretics in subjects with hypertension is associated with the syncope which is mainly mediated with renal impairment and electrolyte disturbances. These results focus on vital role of individualized treatment and careful monitoring approaches for prescription of thiazide diuretics in subjects having hypertension