| Refocus on diuretics in the treatment of heart failure. | |
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MedLine Citation:
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PMID: 8521885 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Diuretics have long been accepted as the traditional first-line treatment of the patient with symptomatic heart failure whatever its aetiology or dysfunctional stage. Their acceptance in this role is based on the rapid improvement in congestive symptoms experienced by most patients, which is arguably greater than that induced by any other currently available anti-heart failure drug. This symptomatic efficacy and their universal clinical acceptance as first-step treatment for the patient with symptoms of heart failure has precluded formal examination of their impact on prognosis. Evidence from indirect studies suggests that when used alone they may not be able to prevent clinical deterioration, possibly due to excitation of the renin-angiotensin-aldosterone system. When such excitation is suppressed by concomitant administration of angiotensin-converting enzyme inhibitors, relief of congestive symptoms is enhanced and the morbidity and mortality risk of heart failure significantly reduced. Studies on the mechanisms of diuretic resistance have demonstrated the synergy of diuretic activity when low doses of diuretics acting at different sites of the nephron are used in combination. Diuretics remain the cornerstone of treatment for symptoms in congestive heart failure but their overall efficacy is substantially improved when combined with ACE inhibitors. |
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Authors:
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S H Taylor |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: European heart journal Volume: 16 Suppl F ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 1995 Jul |
Date Detail:
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Created Date: 1996-01-24 Completed Date: 1996-01-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 7-15 Citation Subset: IM |
Affiliation:
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Aberford Court, West Yorkshire, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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adverse effects,
therapeutic use Diuretics / adverse effects, therapeutic use* Dose-Response Relationship, Drug Drug Administration Schedule Drug Therapy, Combination Heart Failure / drug therapy*, physiopathology Hemodynamics / drug effects*, physiology Humans Prognosis Renin-Angiotensin System / drug effects, physiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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