Purpose. There are reports indicating that diuretics may increase the risk of gastrointestinal bleeding. The study was conducted to verify this hypothesis and to assess whether the risk varies with the different types of diuretics. / Methods. Using the Saskatchewan health database, a nested case-control design was used, conducted within a population-based cohort of 47,865 new users of antihypertensive medications in Saskatchewan, from 1980 to 1983, and followed up to mid 1987. 753 subjects hospitalized for gastrointestinal bleeding were identified during this period, each of whom was matched with 10 randomly selected controls from a risk set formed at the index date, namely when a case was identified. / Results. The rate of hospitalization for gastrointestinal bleeding in this cohort was 2.83 cases per 1,000 subjects per year. The adjusted rate ratio of gastrointestinal bleeding for current use of any diuretic within the 30-day time window prior to the index date was 1.54 (95% confidence interval, CI 1.27 to 1.86) compared with no current use of antihypertensive medications. Among the different classes, potassium-sparing diuretic are associated with the highest adjusted rate ratios (2.64; 95% CI, 1.35 to 5.16), and current use of combination of thiazide diuretics and potassium sparing with the lowest (1.39; 95% CI, 1.11 to 1.73) in the 30-day time window. The adjusted rate ratio of hospitalization for gastrointestinal bleeding for current use of a daily dose of thiazide diuretics less than 50mg was 1.34; 95% CI, 0.37 to 4.90, and for a daily dose equal to 50 to 60 mg the rate ratio was 1.81; 95% CI, 0.93 to 3.54, while for a daily dose greater than 60mg the rate ratio was 2.99; 95% CI, 1.14 to 7.84 within the 30-day time window. Results were similar when a 60-day exposure time window was used. Higher doses of furosemide (loop diuretic) were positively associated with hospitalization for gastrointestinal bleeding. / Conclusion. Diuretic use appears to increase the risk of gastrointestinal bleeding.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33072 |
| Date | January 2001 |
| Creators | Blay, Daniel. |
| Contributors | Suissa, Samy (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001838534, proquestno: MQ80110, Theses scanned by UMI/ProQuest. |
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