Fluid restriction doesn’t enhance well being in coronary heart failure sufferers

Individuals with coronary heart failure have lengthy been suggested to restrict the quantity of fluids they eat every day to assist scale back congestion, or the buildup of fluid within the lungs and extremities, however that recommendation supplies no profit, based on a research offered on the American Faculty of Cardiology’s Annual Scientific Session (ACC.25).

Coronary heart failure happens when the center turns into too stiff or too weak to successfully pump blood all through the physique. Congestion is a typical symptom that may trigger swelling and shortness of breath. To assist scale back this, U.S. and European medical pointers advocate limiting every day fluid consumption to about six cups (1,500 milliliters). Nevertheless, proof for this advice is missing and specialists have debated whether or not proscribing fluid consumption is critical.

This research is the primary giant randomized managed trial to guage how liberal versus restricted fluid consumption impacts well being standing in sufferers with coronary heart failure. The outcomes confirmed a development towards improved well being standing for these with unrestricted fluid consumption however the distinction between research teams was not statistically important for the research’s main endpoint. Thirst was increased in these with fluid restriction, whereas there was no distinction in any of the exploratory security outcomes.

Our conclusion is that in sufferers with steady coronary heart failure there isn’t a want for fluid restriction. This is a vital message to coronary heart failure sufferers everywhere in the world and might be carried out instantly.”

Roland van Kimmenade, MD, heart specialist at Radboud College Medical Heart in Nijmegen, Netherlands, and research’s senior writer

The trial, referred to as FRESH-UP, enrolled 504 folks with coronary heart failure at seven medical facilities within the Netherlands. Research members have been 69 years outdated on common, about two-thirds have been males, and all had coronary heart failure with delicate to reasonable signs however have been comfy at relaxation. About half of the members had coronary heart failure with decreased ejection fraction and half had preserved ejection fraction, representing the 2 sorts of coronary heart failure. Most members have been taking normal coronary heart failure medicines and about half have been taking loop diuretics, a sort of drug that helps to handle swelling and fluid retention.

Half of the members have been assigned to restrict their every day fluid consumption to 1,500 mL and half have been instructed to drink as a lot as they wished. At three months, researchers assessed members’ well being standing utilizing the Kansas Metropolis Cardiomyopathy Questionnaire (KCCQ) and located no statistically important distinction between teams.

Researchers mentioned that a number of elements might have affected the outcomes. One unexpected discovering was that about half of the sufferers had not been suggested to restrict their fluid consumption earlier than enrolling within the research. Second, members had increased scores for well being standing at baseline than anticipated. On condition that the research inhabitants had a comparatively excessive baseline well being standing and lots of have been already on a routine of liberal fluid consumption, it was difficult for the research to display a major profit from liberal fluid consumption versus fluid restriction. In response to the researchers, this may increasingly have led to the non-significant outcomes of the first end result.

General, the distinction in fluid consumption between the 2 teams was comparatively modest. Sufferers assigned to fluid restriction consumed a median of 1,480 mL per day and people assigned to unrestricted fluid consumption consumed a median of 1,760 mL per day, a median distinction of lower than 10 ounces. Individuals assigned to limit their fluid consumption reported extra thirst. Importantly, there have been no variations between teams when it comes to loss of life, coronary heart failure hospitalizations, want for intravenous diuretics or acute kidney damage at six months.

“We didn’t discover any sign within the main or security outcomes that fluid restriction contributes to something or that liberal fluid consumption would result in any hurt,” van Kimmenade mentioned. “Accordingly, our outcomes query the necessity for fluid restriction in sufferers with steady coronary heart failure.”

Though the research was performed in a single nation, researchers mentioned that the findings would probably be generalizable to different developed nations the place some clinicians routinely advise fluid restriction for sufferers with coronary heart failure and others don’t.

The research was funded by the Dutch Coronary heart Basis and a Radboud UMC /Maastricht UMC inter-university grant.

This research was concurrently revealed on-line in Nature Drugs on the time of presentation.