RESEARCHThiamin Status, Diuretic Medications, and the Management of Congestive Heart Failure
Section snippets
Materials and Methods
This study was a cross-sectional investigation of thiamin status of consecutively treated patients of a cardiology clinic in a large, midwestern, tertiary care medical center.
Results
Thirty-eight patients with congestive heart failure participated in the study. The group comprised 29 men and 9 women; 30 were white and 8 were nonwhite; mean age (±standard deviation [SD]) was 55±14 years and median age was 56 years (range=20 to 79 years). Most subjects were being treated as outpatients; however, 11 were admitted to the inpatient service of the medical center.
Analysis of the clinical data revealed that 24 of the patients had ischemic heart disease and 14 had nonischemic heart
Discussion
Biochemical evidence for thiamin deficiency was found in one fifth of the study population of patients with congestive heart failure who were treated with loop diuretic therapy. This finding supports previous suggestions of a high prevalence of thiamin deficiency in patients with congestive heart failure treated with loop diuretic therapy (5), (7), (7). In our study, men and nonwhite patients with congestive heart failure appeared most likely to have evidence of thiamin deficiency, although
Applications
In-depth nutrition assessment of thiamin status, including dietary intake, may be an important component of care for patients with congestive heart failure who are being treated with loop diuretic therapy. The relative contributions of etiologic factors that increase the risk for thiamin deficiency in these patients and the efficacy of intervention remain to be determined. Confirmation of a specific drug-nutrient interaction awaits controlled clinical trials. Attention to thiamin status is of
References (24)
- et al.
Congestive heart failurecurrent controversies and future prospects
Am J Cardiol.
(1990) - et al.
Thiarnine deficiency in patients with congestive heart failure receiving long-term furosemide therapya pilot study
Am J Med.
(1991) Functional evaluation of nutritional statusthiamine
- et al.
Estimates of nutrient intake from a food frequency questionnaire
J Am Diet Assoc.
(1992) Interpretations of requirements for thiamin, riboflavin, niacin-tryptophan, and vitamin E plus comments on balance studies and vitamin B-6
Am J Clin Nutr.
(1986)- et al.
Trends in hospitalization rates for heart failure in the United States, 1973–1986evidence for increasing population prevalence
Arch Intern Med.
(1990) - (1991)
Clinical trials of diuretic therapy in heart failureresearch directions and clinical considerations
J Am Coll Cardiol.
(1993)- et al.
A clinical study on thiamin deficiency
Jpn Circ J.
(1979) Furosemide-induced thiamin deficiency
Cardiovasc Res.
(1980)
Thiamin
Evaluation of the patient with cardiovascular disease
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Prevalence of Thiamin Deficiency in Ambulatory Patients with Heart Failure
2019, Journal of the Academy of Nutrition and DieteticsD-Ribose as a Contributor to Glycated Haemoglobin
2017, EBioMedicineCitation Excerpt :According to Coy et al. (2005), TK levels are markedly decreased in T2DM patients. Thiamine deficiency, as a major risk factor, is widely accepted to be associated with the decrease in TK activity (Brady et al., 1995; Lonsdale, 2015). However, according to the work of Michalak et al. (2013), the decrease in TK activity associated with diabetic neuropathy may be independent of thiamine deficiency.
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2017, Journal of Fluency DisordersPrevalence of thiamine deficiency in a stable heart failure outpatient cohort on standard loop diuretic therapy
2016, Clinical NutritionCitation Excerpt :The increased urinary loss of thiamine with loop diuretic use has been hypothesized to potentiate a thiamine deficiency in HF patients – exacerbating their symptoms [9]. This hypothesis is supported by a reported prevalence of thiamine deficiency as high as 96% in blood samples of HF patients [6–8,10–14]. These findings are juxtaposed, however, by multiple studies finding no evidence of deficiency, or no difference in thiamine status between HF patients and controls [15–18].