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Diuretics for heart failure
The Cochrane Database of Systematic Reviews
|January 27, 2006
Summary
Diuretics significantly reduce mortality and hospitalizations for worsening heart failure in chronic heart failure patients compared to placebo. These drugs also improve exercise capacity when compared to other active treatments.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic heart failure (CHF) is a leading global cause of illness and death.
- Diuretics are a standard first-line treatment for CHF, offering symptomatic relief.
- The impact of diuretics on CHF progression and patient survival remains uncertain.
Purpose of the Study:
- To evaluate the benefits and harms of diuretic use in patients with chronic heart failure.
Main Methods:
- Systematic review and meta-analysis of double-blinded randomized controlled trials.
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, HERDIN) and contacted manufacturers.
- Included trials comparing diuretics to placebo or other active agents (ACE inhibitors, digoxin) in CHF patients.
Main Results:
- 14 trials with 525 participants were included; 7 placebo-controlled and 7 active-controlled.
- Diuretics significantly reduced mortality (OR 0.24, P=0.02) and hospital admissions for worsening heart failure (OR 0.07, P=0.01) versus placebo.
- Diuretics improved exercise capacity compared to active controls (WMD 0.72, P<0.0001).
Conclusions:
- Conventional diuretics appear to decrease the risk of death and heart failure exacerbation in CHF patients compared to placebo.
- Diuretics demonstrate an improvement in exercise capacity when contrasted with active treatments in CHF management.
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