Association between diuretic use, clinical response, and death in acute heart failure

Congestive heart failure (CHF) is common,(1,2) particularly among the elderly, and is associated with high rates of morbidity and mortality.(2,3) Diminished responsiveness to the clinical effect of diuretic drugs is known to complicate the treatment of this syndrome.(4) The impact of angiotensin-converting enzyme inhibitors on mortality in CHF is known(5,6); the effect of digitalis has been studied more recently.(7) However, little is known about the association between diuretic use, clinical response to these agents, and clinical outcomes. To better understand the association between diuretic response during the subacute period of hospitalization and outcomes, we examined the medical records of patients hospitalized for evaluation and treatment of CHF.