Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials

Abstract

Aim: This umbrella review aimed to summarize the literature on the efficacy and safety of chronic diuretic treatment in adults. Findings: Certain diuretics or diuretic subclasses offer significant benefits for key clinical outcomes, such as reducing cardiovascular mortality and heart failure-related hospitalizations. However, chronic diuretic use carries potential risks, including an increased risk of hyperkalemia, with age-related differences in adverse event risks [older adults (≥ 65 years) facing higher risks, while younger populations do not show similar concerns]. Message: Further research is needed to establish diuretic efficacy and safety in populations commonly seen in clinical practice, especially older adults living with multimorbidity and frailty.