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Nijmegen, Netherlands – In a significant shift from long-standing medical advice, a groundbreaking study led by Radboud University Medical Center has revealed that patients with stable heart failure can safely drink fluids without adhering to strict limitations. The research, published in Nature Medicine, challenges the conventional practice of advising heart failure patients to restrict their fluid intake to 1.5 liters per day.
The study, the first large-scale investigation of its kind, found no health benefits associated with fluid restriction in these patients. Researchers observed no differences in health status, hospital admissions, mortality, or medication use between patients who limited their fluid intake and those who did not. The only notable difference was that the restricted group reported increased thirst.
“The idea is that drinking less would help retain less fluid,” explains cardiologist Roland van Kimmenade from Radboudumc. “But when you think about it, this isn’t as logical as it initially seems. The fluid doesn’t accumulate in the areas that cause problems in heart failure.”
The study involved 506 stable heart failure patients across seven hospitals. Half of the participants were advised to limit their fluid intake to 1.5 liters per day, while the other half were allowed to drink freely. Over three months, researchers monitored various health indicators, including quality of life, thirst, and safety.
The results showed that patients in the unrestricted group consumed approximately 300 milliliters more fluid daily, roughly equivalent to two cups of coffee. This seemingly small difference significantly impacted their perceived thirst levels.
“This might not seem like much, but it appears to be the difference between experiencing thirst or not,” says researcher Job Herrmann. “And it aligns with what people over sixty typically drink per day, as they naturally drink less than younger individuals.”
The finding is significant as fluid restriction has been known to cause stress, frustration, and social challenges for patients, constantly reminding them of their condition.
“Our findings show that fluid restriction is unnecessary for stable heart failure patients. This is important for patients worldwide and can be applied immediately. Based on this study, global guidelines can now be updated,” concludes van Kimmenade.
Heart failure, a condition affecting one in five people over sixty in Western countries, occurs when the heart struggles to pump blood effectively, leading to fluid buildup in the lungs. This study, supported by the Dutch Heart Foundation and the Academic Alliance Fund with MUMC+, provides crucial evidence that could revolutionize patient care.
More information: Job J. Herrmann et al, Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial, Nature Medicine (2025). DOI: 10.1038/s41591-025-03628-4
Disclaimer: This news article is based on the provided research and should not be taken as medical advice. Individuals with heart failure should always consult with their healthcare provider before making any changes to their diet or fluid intake. This study focused on stable heart failure patients, and its findings may not apply to all individuals with heart failure, especially those with acute conditions or other complicating factors.
