Document Detail

Withdrawal of long-term diuretic medication in elderly patients: a double blind randomised trial.
MedLine Citation:
PMID:  9284668     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: About 20% of elderly people use long-term diuretic medication, but there is doubt whether prolonged diuretic medication on such a large scale is necessary. We performed a study to assess what proportion may successfully be withdrawn from diuretic therapy. DESIGN: Double blind randomised controlled trial with six month follow up. SETTING: General practice. SUBJECTS: 202 patients taking long-term diuretics without manifest heart failure or hypertension. INTERVENTIONS: Patients were allocated to either placebo (withdrawal group, n = 102) or continuation of diuretic treatment (control group, n = 100). MAIN OUTCOME MEASURE: Occurrence of clinical conditions requiring diuretic therapy based on fixed criteria. RESULTS: During follow up diuretic therapy was required in 50 patients in the withdrawal group and 13 in the control group (risk difference 36%; 95% confidence interval 22% to 50%). Heart failure was the most frequent cause of prescribing diuretic therapy (n = 25). Cessation of diuretic therapy caused a mean increase in systolic blood pressure of 13.5 (9.2 to 17.8) mm Hg and in diastolic pressure of 4.6 (1.9 to 7.3) mm Hg. CONCLUSION: Withdrawal of long-term diuretic treatment in elderly patients leads to symptoms of heart failure or increase in blood pressure to hypertensive values in most cases. Any attempt to withdraw diuretic therapy requires careful monitoring conditions, notably during the initial four weeks.
E P Walma; A W Hoes; C van Dooren; A Prins; E van der Does
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  315     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-09-22     Completed Date:  1997-09-22     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  464-8     Citation Subset:  AIM; IM    
Department of General Practice, Erasmus University Medical School, Rotterdam, Netherlands.
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MeSH Terms
Blood Pressure / drug effects
Cardiac Output, Low / drug therapy
Diuretics / therapeutic use*
Double-Blind Method
Follow-Up Studies
Hypertension / drug therapy
Patient Compliance
Substance Withdrawal Syndrome / etiology
Reg. No./Substance:
Comment In:
BMJ. 1998 Feb 21;316(7131):628   [PMID:  9518931 ]

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