They are not very effective in heart failure.
These include:
- Hydralazine.
- Calcium channel blockers (diltiazem, nifedipine) may have a detrimental effect on left ventricular functions and better to be avoided in heart failure.
- Combination of nitrites (venodilator) and hydralazine (arteriolar vasodi/ators)
- can be used in patients with contraindications to ACEls.
- It act on the sino-atrial node reducing the heart rate.
- Can be used in severely symptomatic CHF patients with sinus rhythm and reduced
- ejection fraction (less than 35 %) and heart rate more than 70 per minute