Risk of Benign Paroxysmal Positional Vertigo Modified by Diuretics-A Population-Level Case-Control Study

Area of Science:

• Otolaryngology
• Pharmacology
• Epidemiology

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
• Diuretic medications are frequently prescribed for various conditions.
• The relationship between diuretic use and BPPV is not well-established.

Purpose of the Study:

• To investigate the association between diuretic use and BPPV.
• To compare diuretic use patterns in patients with and without BPPV.
• To explore diuretic use in related vestibular disorders like Ménière's disease (MD).

Main Methods:

• A case-control study utilizing the TriNetX US Collaborative Network database.
• Patients were stratified by age and sex, with exclusion criteria for head trauma, ear surgery, central vertigo, and migraine.
• Chi-square analysis compared diuretic use and vitamin D deficiency prevalence between case and control cohorts.

Main Results:

• Diuretic use was more prevalent in BPPV case cohorts compared to controls.
• In vestibular patients, thiazide and carbonic anhydrase inhibitor (CAI) use was higher in controls, while loop diuretic use was lower.
• Ménière's disease (MD) patients showed higher thiazide and loop diuretic use in controls, with no significant difference in CAI use.

Conclusions:

• All classes of diuretics may influence BPPV risk, with effects potentially being favorable or unfavorable.
• The impact of diuretics on BPPV risk may depend on individual patient medical history.
• The efficacy of specific diuretic classes, rather than their mechanisms, might be more relevant to their effects on BPPV.