Diuretic Management in Heart Failure
Article first published online: 23 JUL 2010
© 2010 Wiley Periodicals, Inc.
Congestive Heart Failure
Special Issue: Volume Overload, Renal Function, and Heart Failure: Diagnostic and Management Strategies
Volume 16, Issue Supplement s1, pages S68–S72, July/August 2010
How to Cite
Michael Felker, G. (2010), Diuretic Management in Heart Failure. Congestive Heart Failure, 16: S68–S72. doi: 10.1111/j.1751-7133.2010.00172.x
- Issue published online: 23 JUL 2010
- Article first published online: 23 JUL 2010
- Manuscript received March 30, 2010; accepted April 4, 2010
Congest Heart Fail. 2010;16(4)(suppl 1):S68–S72. ©2010 Wiley Periodicals, Inc.
Many of the primary clinical manifestations of heart failure are due to fluid retention and congestion, and therefore treatments targeting congestion play a central role in heart failure management. Diuretic therapy remains the cornerstone of congestion treatment, and diuretics are prescribed to the majority of heart failure patients. Despite this ubiquitous use, there is limited evidence from prospective randomized studies to guide the use of diuretics. Some observational data have suggested that diuretics may actually be harmful in heart failure, potentially contributing to worsening renal function, neurohormonal activation, and even heart failure progression. Recent clinical trial data have provided new insights into the balance of risks and benefits from diuretics. This review describes the mechanism of action of available diuretic classes, reviews their clinical use based on current guidelines, and briefly discusses evolving alternatives to diuretic therapy in the management of congestion in heart failure patients.