Summary
Sixty patients were treated for 1 year for essential uncomplicated hypertension, 30 with beta-blockers alone (BB) and 30 with BB and chlorthalidone (CTD). BB did not affect serum K+ or Mg++. In the BB-group there was a statistically significant trend towards retention of Mg++ in a loading test, but the effect was clinically marginal. BB + CTD reduced serum K+ and Mg++ and caused significant Mg++ depletion, as shown by the Mg++ loading test. All the effects were highly significant and were clinically important. The metabolic perturbations due to CTD are potentially dangerous and make this drug unattractive as ‘first choice’ treatment for hypertension.
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References
Günther T (1981) Biochemistry and pathobiochemistry of magnesium. 3rd Internat. Symp. on Magnesium. Baden-Baden 1981, Magnesium Bulletin 3: 91–101
Altura BMA, Altura BT (1984) Magnesium, electrolyte transport and coronary vascular tone. Drugs 28 [Suppl] 1: 120–142
Leary WP, Reyes AJ (1984) Diuretic-induced magnesium losses. Drugs 28 [Suppl 1]: 143–150
Ross EJ (1975) Aldosterone and aldosteronism. Lloyd-Luke, London, pp 93–113
Swales JD (1982) Magnesium deficiency and diuretics. Br Med J 285: 1377–1378
Dyckner T, Wester PO, Widman L (1981) Potassium- and magnesiumsparing diuretics: Effects on skeletal muscle electrolytes. 3rd Internat. Symp. on Magnesium. Baden-Baden 1981, Magnesium Bulletin 3: 105–109
Duarte CG (1968) Effects of ethacrinic and frusemide on urinary calcium, phosphate and magnesium. Metabolism 17: 867–876
Lim P, Jacob E (1972) Magnesium deficiency in patients on long-term diuretic therapy for heart failure. Br Med J 3: 620–622
Whang R (1984) Magnesium deficiency. Causes and implications. Drugs 28 [Suppl 1]: 143–150
Wester PO, Dyckner T (1981) The role of magnesium in repletion of potassium. 3rd Internat. Symp. on Magnesium. Baden-Baden 1981, Magnesium Bull 3: 91–103
Altura BMA, Altura BT (1983) Magnesium-calcium interaction and contraction of arterial smooth muscle in ischemic heart disease, hypertension, and vasospastic disorders. In: Wester (ed) Electrolytes and the heart. Trans Medica Inc, NY (1983), pp 41–56
Commerford PJ, Lloyd EA (1984) Arrhythmias in patients with drug toxicity, electrolyte, and endocrine disturbances. Symp. on Cardiac Arrhythmias II. Med Clin North Am 68: 1051–1078
Cadell JL, Saier FL, Thomason CA (1975) Parenteral magnesium load test in postpartum American women. Am J Clin Nutr 28: 1099–1104
Cadell JL (1975) The magnesium load test. A design for infants. Clin Pediatr 14: 449–459
Iseri LT, Freed J, Bures AR (1975) Magnesium deficiency and cardiac disorders. Am J Med 58: 837–845
Winer BJ (1971) Statistical principles in experimental design, 2nd edn. McGraw Hill, New York
Geisser S, Greenhouse S (1958) An extension of Box's results on the use of F distribution in multivariate analysis. Ann Math Statist 29: 885–891
BMDP Statistical Software (1983) Dixon WJ (ed) University of California Press, Los Angeles
Welb S, Schade DS (1975) Hypomagnesemia as a cause of persistent hypokalemia. J Am Med Assoc 233: 23–24
Caplan M, Hastillo A, Mohakumar T, Hess ML (1984) Immunologic mechanisms in the atherosclerotic process. Cardiovasc Rev Rep 5: 713–721
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Cocco, G., Iselin, H.U., Strozzi, C. et al. Magnesium depletion in patients on long-term chlorthalidone therapy for essential hypertension. Eur J Clin Pharmacol 32, 335–338 (1987). https://doi.org/10.1007/BF00543964
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DOI: https://doi.org/10.1007/BF00543964