Reappraisal of the role of diuretics in heart failure.

The focus of this review is to explore the controversy between the broad acceptance of loop diuretics as a first-line treatment for heart failure (HF) and the data regarding their association to increased morbidity and mortality in HF. We conclude that existing evidence is sufficient to recognize that diuretics are essential for the management of HF. Selection bias is the likely source of their connection to poor outcomes.