The metabolic effects of thiazide therapy in the elderly: a population study

The metabolic consequences of thiazide diuretics are well known. The elderly to whom these agents are widely prescribed may be particularly susceptible. To quantify this metabolic risk, plasma and intracellular electrolytes and plasma glucose were measured in the elderly population of a Somerset village. Highly significant reductions in both plasma and cellular magnesium and potassium were found in the 47 thiazide-treated people. Forty-eight per cent of the thiazide-treated group were hypomagnesaemic and 28% were hypokalaemic. Thus, magnesium and potassium depletion are commonly associated with thiazide therapy in the elderly. These metabolic effects should be considered carefully prior to the use of these agents.