Diuretics in the treatment of patients who present congestive heart failure and hypertension

Abstract

The main operational objective of diuretic therapy in patients who present congestive heart failure and hypertension is to reduce or to suppress excess bodily fluid. Effective diuretic therapy decreases cardiac size when the heart is dilated, and it reduces lung congestion and excess water. Consequently, external respiratory work diminishes and cardiac output would be redistributed in favour of systemic vascular beds other than that of the respiratory muscles; dyspnoea decreases markedly and there is a slight reduction in fatigue. This clinical improvement and the fall in body weight caused by diuretics entail an increase in effort capacity. Subsequent exercise training ameliorates the abnormal ventilatory response to physical effort and the skeletal muscle myopathy that occur in heart failure, and thereby it attenuates dyspnoea and decreases fatigue further. Loop and/or thiazide-type diuretics may be used to aug-

Predictors of fatigue in patients with heart failure

“…2002). In addition, Reyes (2002) found that diuretics may improve the symptoms of hypertension, heart enlargement and pleural effusion, thereby decreasing the workload of respiratory muscles and relieving difficulty with breathing and fatigue.…”

“…The influence of diuretic therapy on fatigue may be explained by its contribution to increased frequency of urination and urgency, loss of sleep because of disrupted sleep patterns and early awakening and electrolyte imbalance (Bennett et al 2000, Nohria et al 2002. In addition, Reyes (2002) found that diuretics may improve the symptoms of hypertension, heart enlargement and pleural effusion, thereby decreasing the workload of respiratory muscles and relieving difficulty with breathing and fatigue.…”

Perindopril/Indapamide/Amlodipine in Hypertension: A Profile of Its Use

“…Cough, a well-known class effect of ACE inhibitors, is less frequent with PER than with other drugs in this class, and it can be mitigated by the addition of a CCB, such as AML [ 59 ]. PER reduces AML-induced oedema [ 60 ] and it can correct kaliuresis induced by diuretics, such as IND [ 61 ]. Consistent with these counterbalancing actions, PER/IND/AML is associated with low incidences of cough and oedema, and these AEs are easily manageable.…”