Although widely used for quick relief of CHF symptoms -- cough, shortness of breath and swelling in the feet, legs and ankles -- up until now it was not known whether diuretics had a more substantial effect in treating CHF.

"The available data from several small trials show that in patients with chronic heart failure, conventional diuretics appear to reduce the risk of death and worsening heart failure compared to placebo," according to the review team led by Dr. Rajaa Faris of Saudi Arabia.

Diuretics should be not be the sole medication, rather, they should be used along with other heart medications in treating CHF, the reviewers said.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The researchers looked at data from 525 patients from 14 randomized clinical trials -- seven comparing diuretics with placebo and seven comparing diuretics with other heart medications in treating CHF. The studies involved three types of diuretics: thiazide, potassium-sparing and loop diuretics, such as Lasix. Sixty-one percent of the participants were men with an average age of 59.

The authors estimate that "80 deaths could be avoided for every 1,000 patients treated" with diuretics for CHF, but add that this evidence was based on only 15 deaths out of 221 participants from the studies that reported mortality rates.

CHF, also known as heart failure and cardiac failure, involves a decrease in the heart's ability to pump blood efficiently through the body, leading to a lower delivery
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Contact: Rajaa Faris
rajaa_faris18@hotmail.com
Center for the Advancement of Health
13-Feb-2006