Aim:

To know the quantitative composition of sodium in effervescent pharmaceutical forms and in solutions of analgesics, calcium supplements and mucolytics used chronically; to evaluate in what proportion the potential risk is taken into account when prescribing these drugs to hypertensive patients and to analyze whether the taking of these pharmaceutical forms by the hypertensive population was accompanied by a decompensation of blood pressure (BP) values.

Methods:

The percentage of hypertensive patients treated with effervescent paracetamol, calcium and acetylcysteine (bicarbonate and sodium carbonate) in 10 Primary Care Centers wascalculated. A retrospective cohort study with a control group (adjusted for ageand gender) was carried out in one of the centers. The follow-up was oneyear. The study variables were systolic (SBP) and diastolic (DBP) pre-post initiation of treatment with effervescent preparations, considering clinically relevant increases >5 mmHg; intensification of antihypertensive treatment.

Results:

7.7% (range 5.4%-9.9%) of hypertensive patients were treated with the study effervescent drugs. The percentage of hypertensive patients who showed a relevant increase in SBP was significantly higher in the group treated with effervescent drugs compared to the control group: 35.9% (95% CI 27.2%-44.6%) vs. 18.8% (95% CI 12.7%-24.8%) and also regarding the intensification of antihypertensive treatment, 46.6% (95% CI 37.5%-55.6%) vs. 30% (95% CI 22.9%-37.1%).

Conclusions:

Sensitivity to the potential adverse effect is highly variable. Effervescent medications that include sodium carbonate-bicarbonate can increase BP. The use of effervescent pharmaceutical forms, especially in patients at risk, should be avoided.

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