Abstract
BackgroundThirst is a troublesome symptom in patients with Heart Failure (HF) and one that might be perceived differently in different countries depending on climate, food and cultural habits. The aims of the study were to describe thirst frequency, duration and intensity and to identify factors associated with frequent thirst in outpatients with HF in a Mediterranean country. MethodsData was collected in a cross-sectional study involving 302 patients diagnosed with HF (age 67±12 years, 74% male, LVEF 43%±14) in Spain on thirst frequency and duration, and thirst intensity by patient self-report (VAS, 0-100 mm). Clinical variables were collected from the medical files. Regression analysis was used to identify factors independently associated with frequent thirst. ResultsOf all the patients, 143 (47%) were frequently thirsty, and their median (25th and 75th percentiles) thirst intensity was higher (VAS 50 mm [20-67] vs 7 [0-20], p<.001). Their thirst lasted longer compared to those who never/sometimes were thirsty (p<.001). Less treatment with angiotensin receptor blockers (Odds Ratio [OR] 2.72; 95% Confidence Interval [CI] 1.33–5.58), diuretics >40 mg/day (OR 1.92; 95% CI 1.02-3.64), depression (OR 2.99; CI 1.17–7.62), male gender (OR 1.98; CI 1.08–3.64) and worse New York Heart Association functional class (OR 1.92; 95% CI 1.05-3.52) were independently associated with frequent thirst. ConclusionsAbout half of patients with HF and fluid restriction experienced frequent thirst in a Mediterranean area of Spain, and their thirst duration and intensity were significantly increased. Frequent thirst was associated with demographic, clinical and therapeutic variables. The results may help to identify patients with a higher risk of frequent thirst and might suggest therapeutic changes in order to diminish this troublesome symptom.
Highlights
Thirst in heart failure (HF) has been described ever since the middle ages and renaissance, but only a few studies have been published having thirst as an outcome.1À9 Thirst is a subjective sensation that causes a strong behavioural urge to drink water that cannot be ignored,[10] and for patients with Heart Failure (HF) thirst can be increased and troublesome.1À8,11 Thirst is primarily regulated by the intra- and extracellular mechanisms leading to stimulation of the thirst centre in the brain
Previous studies from the Netherlands, Japan and Sweden show that several factors, such as HF symptoms, male gender, higher level of plasma urea, worse physical function, anxiety, depressive symptoms, diuretics and fluid restriction have been associated with thirst.2À6,8 In a study from the Netherlands, every fifth HF patient experienced persistent thirst during an 18-month follow-up period, meaning that thirst can be a serious problem for many HF patients.[8]
Data was collected on thirst intensity, thirst frequency and thirst duration, and on sociodemographic and clinical variables
Summary
Thirst in heart failure (HF) has been described ever since the middle ages and renaissance, but only a few studies have been published having thirst as an outcome.1À9 Thirst is a subjective sensation that causes a strong behavioural urge to drink water that cannot be ignored,[10] and for patients with HF thirst can be increased and troublesome.1À8,11 Thirst is primarily regulated by the intra- and extracellular mechanisms leading to stimulation of the thirst centre in the brain. Thirst is a troublesome symptom in patients with Heart Failure (HF) and one that might be perceived differently in different countries depending on climate, food and cultural habits. The aims of the study were to describe thirst frequency, duration and intensity and to identify factors associated with frequent thirst in outpatients with HF in a Mediterranean country. Methods: Data was collected in a cross-sectional study involving 302 patients diagnosed with HF (age 67§ 12 years, 74% male, LVEF 43%§14) in Spain on thirst frequency and duration, and thirst intensity by patient self-report (VAS, 0-100 mm). Conclusions: About half of patients with HF and fluid restriction experienced frequent thirst in a Mediterranean area of Spain, and their thirst duration and intensity were significantly increased. The results may help to identify patients with a higher risk of frequent thirst and might suggest therapeutic changes in order to diminish this troublesome symptom
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