Although diuretics are essential to optimize volume status in patients with heart failure with reduced ejection fraction (HFrEF) [1], safety and benefits of prolonged diuretic treatment are uncertain, in particular on patients with chronic and compensated HFrEF. In facts, diuretics can increase the neuro-humoral activation in HFrEF [2], determine electrolyte disturbances [3] and acute renal insufficiency [4]. On the contrary, Hopper et al. identified seven studies of diuretic withdrawal (DW) in stable chronic HF, in which clinical decompensation was more frequent in the DW group [5].
