Study the effect of Valsartan-Hydrochlorothiazide drugs on the level of blood electrolytes in the sera of hypertensive patients who audited to General Hospital of Samarra


This study involved a comparison of blood electrolytes concentrations that include sodium, chloride, potassium, and phosphate in the sera of hypertensive patients who were taking Valsartan-hydrochlorothiazide 80mg /12.5mg blood pressure-lowering combination drugs who were attending General Hospital of Samarra versus a group of healthy people as a control group.
The results showed a significant decrease in concentrations of Sodium, potassium, chloride and phosphate at the same significant at level p <0.01. A comparison was also made between males of the test group (the patient group) versus males of the control group, the result showed a significant decrease in the concentration of sodium, potassium, chloride and phosphate at a significant level p <0.01. And the comparison of electrolytes concentrations in the test Female group (the patient group) versus the control Female group, showed a significant decrease in the potassium and phosphate concentration at the level o p f <0.01. However, the study did not see any significant differences in the level of chloride and sodium in the women of the test group compared to the control group.


  • Alfarouk KO, Ahmed S, Ahmed A, Elliott RL, Ibrahim ME, Ali HS, Wales CC, et al. (2020). The Interplay of Dysregulated pH and Electrolyte Imbalance in Cancer. Cancers, 12(4): 898.
  • Baginski ES, Foa PP, Zak B (1967) Determination of phosphate: study of labile organic phosphate interference. Clinica Chimica Acta, 15(1): 155-158.
  • Baumann M, Eastell R, Hoyle N, Wieczorek L (2001) Bone markers: biochemical and clinical perspectives. Taylor & Francis.
  • Belai N, Gebrehiwet S, Fitsum Y, Russom M (2018) Hydrochlorothiazide and risk of hearing disorder: a case series. Journal of medical case reports, 12(1): 135.
  • Beyer KH (1993) Chlorothiazide. How the thiazides evolved as antihypertensive therapy. Hypertension, 22(3): 388-391.
  • Buettner GR (1993) The Pecking Order of Free Radicals and Antioxidants: Lipid Peroxidation, -Tocopherol, and Ascorbate. Archives of biochemistry and biophysics, 300(2): 535-543.
  • Burtis CA, Bruns DE (2014) Tietz fundamentals of clinical chemistry and molecular diagnostics-e-book. Elsevier Health Sciences.
  • Caravaca F, García-Pino G, Martínez-Gallardo R, Ferreira-Morong F, Luna E, Alvarado R, Ruiz-Donoso E, Chavez E, Chávez E (2013) Increased serum phosphate concentrations in patients with advanced chronic kidney disease treated with diuretics. Nefrología (English Edition), 33(4): 486-494.
  • Crook MA (1994) Hypophosphataemia and hypokalaemia in patients with hypomagnesaemia. British journal of biomedical science, 51(1): 24-27.
  • Gaasbeek A, Meinders AE (2005) Hypophosphatemia: an update on its etiology and treatment. The American journal of medicine, 118(10): 1094-1101.
  • Gales BJ, Bailey EK, Reed AN, Gales MA (2010) Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for the prevention of migraines. Annals of Pharmacotherapy, 44(2): 360-366.
  • Hageman S, Kovalchuk MO, Sleutjes BT, van Schelven LJ, van den Berg LH, Franssen H (2018). Sodium-potassium pump assessment by submaximal electrical nerve stimulation. Clinical Neurophysiology, 129(4): 809-814.
  • Hamm LL, Hering-Smith KS, Nakhoul NL (2013) May. Acid-base and potassium homeostasis. In Seminars in nephrology (Vol. 33, No. 3, pp. 257-264). WB Saunders.
  • Herlihy H, Maebins NK (2003) The Human body in health and illness, 2nd ed, Elsevier Health Sciences, p343.
  • Hillmann G, Beyer G (1967) Turbidimetric determination of potassium in serum. Z. Klin. Chem. Klin. Biochem, 5(2): 92-93.
  • Jandeleit-Dahm K, Cooper ME (2006) Hypertension and diabetes: role of the renin-angiotensin system. Endocrinology and Metabolism Clinics, 35(3): 469-490.
  • Joshi UH, Solanki VR, Desai TR, Tirgar PR (2012) Investigation of antihypertensive mechanism of Curculigo orchioides in doca salt induced hypertensive rats. Int J Phytopharmacol, 3(2): 178-185.
  • Kelly GS (1997) Hydrochloric acid: physiological functions and clinical implications. Altern Med Rev, 2(2): 116-27.
  • Kim DR, Cho JH, Jang WS, Kim JS, Jeong KH, Lee TW, Ihm CG (2013) Severe hyponatremia associated with the use of angiotensin II receptor blocker/thiazide combinations. Electrolytes & Blood Pressure, 11(2): 56-59.
  • Liamis G, Filippatos TD, Elisaf MS (2016) Thiazide–associated hyponatremia in the elderly: what the clinician needs to know. Journal of geriatric cardiology: JGC, 13(2): 175.
  • Liamis G, Milionis HJ, Elisaf M (2010) Medication-induced hypophosphatemia: a review. QJM: An International Journal of Medicine, 103(7): 449-459.
  • Mahal MH, Thamer HA, Mohammed HE, Hassen OA, Hassan MA (2019) Effect of Non-filtered Drinking Water on Some of the Kidney Functions Compared to Filtered Water in Some People in Bishan Village. Indian Journal of Public Health, 10(11): .3355.
  • Miller WG (1984) Chloride. Kaplan A et al. Clin Chem The CV Mosby Co. St Louis. Toronto. Princeton: 1059-1062.
  • Moe SM (2008) Disorders involving calcium, phosphorus, and magnesium. Primary Care: Clinics in Office Practice, 35(2): 215-237.
  • Moradi M, Farhadian M, Kazemi M (2019) Assessing post-cardiac stress test heart rate recovery and systolic blood pressure recovery in patients suffering from vasovagal syncope. Electronic Journal of General Medicine, 16(2): em118.
  • Mount DB, Zandi-Nejad K (2004) Disorders of potassium balance, 7th ed, Elsevier, Philadelphia: p840.
  • Musini VM, Nazer M, Bassett K, Wright JM (2014) Blood pressure‐lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database of Systematic Reviews, (5).
  • NCD Risk Factor Collaboration (2017) Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19· 1 million participants. Lancet (London, England), 389(10064): 37.
  • Palmer BF (2015) Regulation of potassium homeostasis. Clinical Journal of the American Society of Nephrology, 10(6): 1050-1060.
  • Palmer BF, Naderi ASA (2007) Metabolic complications associated with use of thiazide diuretics. Journal of the American Society of Hypertension, 1(6): 381-392.
  • Raebel MA (2012) Hyperkalemia associated with use of angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers. Cardiovascular therapeutics, 30(3): e156-e166.
  • Stachenfeld NS (2008) Sex hormone effects on body fluid regulation. Exercise and sport sciences reviews, 36(3): 152.
  • Trinder P (1951) A rapid method for the determination of sodium in serum. Analyst, 76(907): 596-599.
  • Wright JM, Musini VM, Gill R (2018) First‐line drugs for hypertension. Cochrane Database of systematic reviews, (4).
  • Yazici O (2018) Erosion Surfaces of the Land Between Iznik-Mekece (Turkey). International Journal of Geography and Geology, 7(1): 1-13.
  • Zillich AJ, Garg J, Basu S, Bakris GL, Carter BL (2006) Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension, 48(2): 219-224.


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