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Decrease in loop diuretic treatment from 2005 to 2014 in Swedish real-life patients with chronic heart failure.

Journal article
Authors Pär Parén
Annika Rosengren
Tatiana Zverkova Sandström
Maria Schaufelberger
Published in European journal of clinical pharmacology
Volume 75
Issue 2
Pages 247-254
ISSN 1432-1041
Publication year 2019
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 247-254
Language en
Links dx.doi.org/10.1007/s00228-018-2574-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Chronic Disease, drug therapy, Diuretics, therapeutic use, Female, Heart Failure, drug therapy, Humans, Male, Middle Aged, Sweden, Young Adult
Subject categories Clinical Medicine

Abstract

Loop diuretics are recommended to treat congestive symptoms in patients with heart failure. However, observational studies have indicated that loop diuretic treatment in heart failure is associated with increased mortality. Therefore, loop diuretic discontinuation or dose reduction, when clinically possible, is recommended. Our aim was to study nationwide temporal trends in loop diuretic treatment from 2005 to 2014 in real-life patients with chronic heart failure.Data from the nationwide Swedish National Patient, Prescribed Drug and Cause of Death Registers were linked. The annual proportions of patients with chronic heart failure treated with loop diuretics from 2005 to 2014 were calculated. In addition, the annual median loop diuretic doses (DDD) in patients with chronic heart failure treated with loop diuretics from 2005 to 2014 were calculated.The proportion of real-life patients with chronic heart failure treated with loop diuretics decreased from 73.2% in 2005 to 65.7% in 2014 (p for trend < 0.001). The median loop diuretic DDD in real-life patients with chronic heart failure decreased from 2.13 (IQR 1.09-2.77) in 2005 to 1.63 (IQR 1.09-2.25) in 2014 (p = 0.001 for trend).Loop diuretic treatment decreased from 2005 to 2014 in real-life patients with chronic heart failure. The prognostic impact of changes in loop diuretic treatment in patients with heart failure remains unclear.

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