Diuretic usage in heart failure: a continuing conundrum. Invited Review

S Gupta, L. Neyses

    Research output: Contribution to journalArticlepeer-review


    Several large well-designed clinical trials have shown that the use of diuretics is beneficial in patients with hypertension. However, similarly robust data regarding their role in chronic heart failure are lacking. Historically, diuretics were developed for treatment of sodium and water retention in oedematous disorders and clinically, they remain the most potent drugs available to relieve symptoms and eliminate oedema in the congested patient with heart failure. In the non-congested patient, however, diuretics continue to be used on a purely clinical basis without sufficient characterization of benefits, adverse effects, and potential influence on mortality. There are also concerns that chronic diuretic usage can cause adverse vascular effects, unfavourable neuroendocrine activation, electrolyte imbalances, and life-threatening arrhythmias. In this article, we review the limited evidence available regarding the benefits and perils of using diuretics in heart failure.
    Original languageEnglish
    JournalEuropean Heart Journal
    Volume26( 7)
    Publication statusPublished - Apr 2005


    • chemically induced: Arrhythmia
    • drug therapy: Cardiac Output, Low
    • adverse effects: Diuretics
    • drug therapy: Heart Failure, Congestive
    • drug effects: Hemodynamic Processes
    • Hospitalization
    • Humans
    • drug effects: Neurosecretory Systems
    • Prognosis
    • Quality of Life
    • physiopathology: Substance Withdrawal Syndrome
    • chemically induced: Water-Electrolyte Imbalance


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