Use of nitrates in acute and chronic congestive heart failure.

The literature available on the use of nitrates (glyceryl trinitrate, isosorbide dinitrate and isosorbide 5-mononitrate) as various formulations (oral, buccal, sublingual, transdermal and intravenous) in the treatment of acute and chronic congestive heart failure is reviewed. There are adequate data on the acute haemodynamic effects of these preparations, but little information is available on the long term use of nitrates in chronic congestive heart failure. The exception is isosorbide dinitrate, which, in combination with hydralazine, has been shown to reduce mortality.