Clinical observations on the diuretic effect of hydrochlorothiazide

Abstract

CLINICAL MATERIAL AND METHODS The effect of hydrochlorothiazide has been studied in a total of thirty-two patients, twenty-six from the clinic or ward population of the House of the Good Samaritan and six from the Cape Cod Hospital. Their ages ranged from five to seventy-six years with a mean of forty-four. Six were males and twenty-six were females. Table I, listing patients according to diagnosis and cause of fluid retention, shows all but three patients had congestive heart failure. The thirty-two patients were observed for a total of 2,741 patient-days with a mean of 85.7 days per patient. Within this observation period hydrochlorothiazide was administered for a total of 1,949 patientdays with a mean of 60.9 days per patient. The dose ranged from 25 to 200 mg. daily. Most patients received 100 to 150 mg. per day in divided doses. Ambulatory Patients: Twenty-six patients were examined weekly on an out-patient basis to evaluate their congestive heart failure. Special forms recording history, physical findings and laboratory data were completed each time. In addition, each patient was asked to collect, measure and record the daily urine output on a specially prepared sheet. About half of the patients cooperated in this task with a high order of accuracy well corroborated by changes in weight. Body weight and average daily urine output, when available, were the chief measures of the degree of fluid retention. Plan of Diuretic Administration: Because most of the ambulatory patients suffered from severe congestive failure and lived at some distance from the hos-