Document Detail

Diuretic therapy in congestive heart failure for the elderly patient.
MedLine Citation:
PMID:  3732094     Owner:  NLM     Status:  MEDLINE    
The incidence of congestive heart failure (CHF) in the elderly increases with age as 80% of patients hospitalised with CHF are older than 60 years of age. In this age group CHF may result from several factors such as coronary artery disease, hypertension, valvular disease or intrinsic myocardiopathies. Important alterations of renal physiology have been observed in this condition: decreases in renal plasma flow and glomerular filtration rate, and increases in renal venous pressure. Natriuretic hormone inhibition occurs and renin-angiotensin-aldosterone system activation and antidiuretic hormone secretion increase, resulting in positive water and sodium balances that contribute to the manifestations of congestive heart failure. The treatment of CHF in the elderly is similar to that in younger patients; the difference in management is determined by the severity of the disease and the side effects of the drugs used. Diuretics increase water and sodium elimination by the kidney and increase the systolic volume of the left ventricle, probably by the reduction of preload and afterload. Diuretic therapy must be pursued carefully in patients receiving digitalis, especially in those elderly individuals who may be on restricted diets: the most common adverse effects of diuretics in this age group are hypovolaemia, hyponatraemia, hypokalaemia and hypomagnesaemia.
E T Carvalho Filho
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Drugs     Volume:  31 Suppl 4     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  1986  
Date Detail:
Created Date:  1986-09-25     Completed Date:  1986-09-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  165-73     Citation Subset:  IM    
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MeSH Terms
Diuretics / adverse effects,  pharmacology,  therapeutic use*
Heart Failure / drug therapy*,  physiopathology
Loop of Henle / drug effects
Metabolic Diseases / chemically induced
Potassium / metabolism
Sodium Chloride Symporter Inhibitors / therapeutic use
Water-Electrolyte Imbalance / chemically induced
Reg. No./Substance:
0/Benzothiadiazines; 0/Diuretics; 0/Sodium Chloride Symporter Inhibitors; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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