ВЛИЯНИЕ ТОРАСЕМИДА И ИНДАПАМИДА НА ЭКСКРЕЦИЮ МАГНИЯ, КАЛИЯ, КАЛЬЦИЯ И НАТРИЯ У ЖЕНЩИН ПОСТМЕНОПАУЗАЛЬНОГО ВОЗРАСТА С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ В ЗАВИСИМОСТИ ОТ НАЛИЧИЯ ДЕФИЦИТА МАГНИЯ

Abstract

The aim of study was to assess torasemide and indapamide effects on magnesium (Mg), potassium (K), calcium (Ca), and sodium (Na) excretion in postmenopausal women with hypertension and heart failure with preserved ejection fraction (HFpEF) depending on Mg exchange. Material and methods. 140 postmenopausal women with hypertension and HFpEF were examined. Based on Mg-tolerance test results, patients were divided into 2 groups: with (n = 72) and without Mg deficiency (n = 68) with randomization into 4 subgroups: 1a, 1b – 36 patients and 2a, 2b - 34 women in each. Subgroups 1a and 2a received torasemide 5 mg, 1b and 2b – indapamide 2.5 mg. Daily diuresis, Na, K, Ca and Mg excretion were determined before and after diuretics use. Results. Diuretics caused equal (p>0.05) increase (p<0.001) in daily urine output and natriuresis by 561 (95%CI: 556–571) ml and 71.0 (95%CI: 68.9– 73.1) mmol/24h. K excretion increased (p<0.0001) only with indapamide use by 21.1 (95% CI: 18.4-23.8) mmol / 24h and 22.3 (95% CI: 19.5-25.0) mmol / 24h in groups 1b and 2b. Mg excretion increase was not detected (p>0.05) only in patients with Mg deficiency torasemide subgroup, but Ca loss remained unchanged (p>0.05) in indapamide subgroups. K/Na and Ca/Na ratio decreased in all groups, while Mg/Na increased with indapamide use and decreased with torasemide use. Torasemide decreased (p<0.001) Mg/Ca excretion ratio, but indapamide decreased (p<0,0001) the one. Conclusion. Indapamide caused significant increase in K, Mg excretion and Mg/Ca, while torasemide increased Ca loss, decreased Mg/Ca, and did not affect K loss in postmenopausal women with hypertension, HFpEF regardless to Mg deficiency. Torasemide did not lead to Mg losses increase in macronutrient-deficiency patients.