What is a common and appropriate approach to edema in HFpEF?

• A. Increase salt intake
• B. Diuretics to address edema
• C. No therapy for edema
• D. Remove diuretics

Answer: (D)

In HFpEF, edema comes from elevated filling pressures due to a stiff ventricle, so relieving fluid overload is the main therapy for symptoms. Diuretics are the cornerstone because they reduce preload and venous congestion, which directly improves edema and related symptoms like shortness of breath and leg swelling. Loop diuretics are commonly used and dosed to achieve euvolemia, guided by weight, edema, and symptoms, while monitoring for dehydration, kidney function, and electrolyte balance. Increasing salt intake would worsen edema, no therapy leaves edema unresolved, and removing diuretics would allow fluid overload to return. So diuretics to address edema is the best approach.