A comparison of three diuretic regimens in heart failure.
Eight patients with mild heart failure were treated in random order for 1 week with 2 mg bumethanide at 0800 and 1200 (treatment 1) h, 1 mg bumethanide at 0800, 1200, 1800, 2200 (treatment 2) and 5 mg bendroflumethiazide at 0800 and 1800 (treatment 3) h. The 'quality of life' did not differ significantly between the three treatment periods. At the presumed trough of the diuretic effect the circulating blood volume was largest during treatment 1; it was 6.3% smaller during treatment 2 (P < 0.02) and 6.7% lower during treatment 3 (P < 0.05). In comparison with treatment 1, the maximal increase in rate-pressure product during physical exercise was 24.6% higher in treatment 3. Compared with treatment 1 the area under the curve (AUC) for plasma lactate during physical exercise was 14% lower during treatment 2 (P < 0.05) and 18% lower during treatment 3 (P < 0.01). These findings suggest that the type of program for diuretic therapy influences the magnitude of inevitable diurnal fluctuations in body fluids, the ability of the heart to work and the ability of the body to adjust to the oxygen demand.
Division of Clinical Pharmacology, University of Aarhus, Denmark.
F
F
Andreasen
U H
UH
Eriksen
S J
SJ
Guul
L P
LP
Nielsen
O M
OM
Bech
B
B
Diamant
O
O
Kahr
P
P
Bruun
O J
OJ
Hartling
S
S
Hvidt
D000368:Aged; D000369:Aged, 80 and over; D001539:Bendroflumethiazide / Q000008:administration & dosage / Q000627:therapeutic use; D001810:Blood Volume / Q000187:drug effects; D002034:Bumetanide / Q000008:administration & dosage / Q000627:therapeutic use; D002940:Circadian Rhythm; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D015444:Exercise / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged
D004232:Diuretics; D007773:Lactates; D002034:Bumetanide; D019344:Lactic Acid; D001539:Bendroflumethiazide