The rationale for the use of oral vasodilator drugs in the pharmacotherapy of CHF derived from the experience with the parenteral agents phentolamine and nitroprusside in patients with severe heart failure and elevated systemic vascular resistance. Although a number of vasodilators may improve symptoms in heart failure, only the hydralazine-isosorbide dinitrate combination and antagonists of the renin-angiotensin system (ACE inhibitors and ATj receptor blockers) have been shown to improve survival in prospective randomized trials. Table 33-1 summarizes some properties of vasodilators used to treat heart failure.

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