The impact of Metolazone plus Furosemide versus Hydrochlorthiazide Plus Furosemide in Patients with Heart failure and refractory edema: A Randomized clinical trial

Abstract

Introduction: Cardiovascular diseases are one of the top 5 causes of death in the world today. Despite numerous clinical trials, no cure has been found for acute heart failure. The only way to treat heart failure is to control it with drugs. One of the common medication regimens used to overcome resistant edema is to use a combination of a Henle loop diuretic with a thiazide group. Thiazide drugs with synergistic mechanism enhance the effectiveness of Henle loop diuretics. However, no research has been done on the effect of metolazone on the potentiation of furosemide. Objective: In this study, the main purpose was to evaluate and compare the effectiveness of furosemide-metolazone with furosemide-hydrochlorothiazide treatment regimen in edema resistant patients with congestive heart failure. Methods: This study was performed as a non-blind randomized trial in Shahid Madani Heart Hospital of Tabriz University of Medical Sciences.46 patients with the condition were randomly divided into two groups of 23 (furosemide-hydrochlorothiazide and furosemide-metolazone). Changes in the levels of elements such as sodium, potassium and calcium within 5 days of hospitalization were evaluated. Also, changes in weight, urinary fluid, urea and creatinine in the blood of patients were examined and evaluated during 5 days. Results: The results showed that there was not a significant difference in the measurement parameters between the group of patients treated with furosemide-hydrochlorothiazide regimen and the group of patients treated with furosemide-metolazone regimen. Conclusion: In this study, it can be concluded that metolazone furosemide treatment regimen can be as effective as furosemide hydrochlorothiazide treatment regimen.