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• Posted November 8, 2022

Study Compares 2 Common Diuretics Used in Heart Failure

Patients with heart failure are often prescribed a diuretic or "water pill" to prevent fluid buildup. A new study has found that two often-prescribed medications work equally well at reducing deaths.

"Given that the two different therapies provide the same effect on outcomes, we shouldn't spend time switching patients from one to the other, and instead concentrate on giving the right dose and adjusting other therapies that have been proven to have long-term benefits," said study lead author and cardiologist Dr. Robert Mentz. He's chief of the heart failure section at Duke University School of Medicine in Durham, N.C.

In the study, researchers compared torsemide (Demadex) and furosemide (Lasix) in more than 2,800 patients with heart failure. While participants were randomly assigned to one drug or the other, doctors decided the dosing.

Prior research suggested torsemide was superior at reducing deaths but the new study did not bear that out.

The study's main question was whether torsemide reduced patient deaths due to any cause over long-term follow-up of an average of more than 17 months.

Death occurred in 373 of 1,431 study participants, or 26%, in the torsemide group. In the furosemide group, 374 people out of 1,428 patients, or 26%, died.

A secondary outcomes analysis looked at deaths or hospitalizations within 12 months. Researchers found little difference. Death or hospitalization occurred in about 47% in the torsemide group and about 49% in the furosemide group.

"This study has immediate clinical applications," Mentz said in a Duke news release. "Doctors spend a lot of time considering whether they will change from one diuretic to another, but there is no difference between the two for outcomes. This provides much-needed clarity."

Heart failure occurs when the heart stops pumping properly. These diuretics are commonly prescribed to reduce the fluid buildup that causes swelling and breathing difficulties in patients with heart failure.

Mentz presented the findings Saturday at the annual meeting of the American Heart Association, in Chicago. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

More information

The American Heart Association has more on heart failure.

SOURCE: Duke Health, news release, Nov. 5, 2022