Loop Diuretic Use in the Months and Years Preceding a Heart Failure Diagnosis: A Case-Control Study

Objective: To understand the prescribing of loop diuretics in primary care patients without a heart failure (HF) diagnosis and to determine if their use signals an increased probability of a future HF diagnosis. Background: Loop diuretics are routinely prescribed for patients with HF to minimize symptoms due to fluid overload but relatively little is known about prescribing patterns in individuals preceding a formal HF diagnosis. Methods: A nested case-control study of 1,288 new-onset (incident) HF cases and 10,319 matched controls was completed with electronic health record (EHR) data extracted between 2001- 2010 from primary care practices affiliated with the Geisinger Health System. New loop diuretic prescriptions, and associated orders Results: Loop diuretic use was significantly greater (11.3% versus 3.5%, p Conclusions: In primary care, loop diuretic use is not uncommon in the months and years preceding a formal incident HF diagnosis. These results suggest there is substantial opportunity to improve the diagnosis and earlier treatment of individuals with HF.