The successful withdrawal of frusemide in 21 out of 190 patients with congestive symptoms attributable to systolic heart failure [1], corroborates the observation made by Oshima et al. that patients with advanced congestive heart failure (CHF) can be discharged on low-dose or no diuretics [2]. In that study, where left ventricular ejection fraction was not specified, the mean age of patients successfully discharged on low-dose (<40mg/day frusemide) or no diuretics was comparable with the mean age of patients discharged on higher doses of diuretics (64.4 vs 68.7, p=0.37), and there was no significant difference in mean plasma concentration of Brain Natriuretic Peptide (BNP) (599.9pg/ml vs 670.4pg/ml) [2].
