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Diuretics in Heart Failure

A Critical Appraisal of Efficacy and Tolerability

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Abstract

Heart failure is a significant cause of morbidity and mortality worldwide. While the aetiology varies and there are a wide variety of treatment options, a large amount of the morbidity related to heart failure is due to fluid retention and the symptoms of volume overload. Multiple neurohormonal pathways are activated in heart failure, and contribute to the symptoms of fluid retention and volume overload. Although not ideal, diuretic therapy is one of the mainstays of treatment of fluid overload in patients with heart failure. This review focuses on the pathophysiology of heart failure leading to volume overload, the different classes of diuretics used in alleviating the symptoms of fluid retention, their mechanisms of action within the kidney, and strategies for using them in ways that minimize their deleterious effects in patients with heart failure.

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Acknowledgements

Neither Anita D. Szady nor James A. Hill have received any type of funding for the preparation of this paper. Neither Dr Szady nor Dr Hill have any conflicts of interest with regards to authorship of this paper and are the sole authors of the article.

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  1. Division of Cardiovascular Medicine, The University of Florida, Box 100277, Gainesville, Florida, 32610-0277, USA

    Anita D. Szady & James A. Hill

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  1. Anita D. Szady
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  2. James A. Hill
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Correspondence to Anita D. Szady.

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Szady, A.D., Hill, J.A. Diuretics in Heart Failure. Drugs 69, 2451–2461 (2009). https://doi.org/10.2165/11319920-000000000-00000

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