Effect of adding hydrochlorothiazide to usual treatment of patients with acute decompensated heart failure: a randomized clinical trial

51 adults (age ≥ 18 years) admitted to the emergency department < 18 h with acute decompensated heart failure (ADHF), systolic dysfunction (LVEF ≤ 45%), and signs of congestion. Mean age 64, mostly white, Brazil-based. Key inclusion criteria: endogenous creatinine clearance > 30 mL/min, serum potassium 3.5 to 5.1 mEq/L.

Hydrochlorothiazide (HCTZ) 50 mg oral once daily added to usual treatment (intravenous furosemide and additional therapies at the discretion of the medical team) for 3 days or until hospital discharge.

Matching placebo oral once daily added to usual treatment (intravenous furosemide and additional therapies at the discretion of the medical team) for 3 days or until hospital discharge.

Daily weight change (reduction) for 3 days, measured daily on the same scale.surrogate