Abstract

For over 25 years diuretics have provided the mainstay of treatment for patients with heart failure. They reduce symptoms in both acute and chronic failure, rarely need to be stopped because of unwanted effects and cost very little. The overall effect of diuretic therapy on long-term mortality is not known, but outlook is certainly improved when an ACE inhibitor is added. In this article we review the use of diuretics in the management of acute and chronic heart failure and consider how they should be integrated with ACE inhibition.