Evidence supporting the use of: Nitrate (unspecified)
For the health condition: Congestive Heart Failure
Synopsis
Source of validity: Scientific
Rating (out of 5): 4
Nitrates, such as nitroglycerin and isosorbide dinitrate, have scientific validation for use in supporting and treating congestive heart failure (CHF), particularly in acute decompensated heart failure and in specific chronic heart failure regimens. Nitrates act as vasodilators, primarily by donating nitric oxide, which leads to relaxation of vascular smooth muscle, resulting in venodilation and, to a lesser extent, arterial dilation. This reduces both preload (venous return to the heart) and, at higher doses, afterload (arterial resistance), thereby decreasing cardiac workload and myocardial oxygen demand. In acute settings, intravenous nitrates can rapidly relieve symptoms such as pulmonary congestion and edema by reducing filling pressures. Several clinical trials, including the landmark V-HeFT (Vasodilator-Heart Failure Trial), have demonstrated the efficacy of a combination of hydralazine and isosorbide dinitrate in reducing mortality and improving symptoms in patients with heart failure, particularly among African American populations. Nitrates are not usually first-line therapy for chronic CHF but are often used adjunctively, especially for patients with persistent symptoms despite standard therapy or those intolerant to other medications. Their role is less prominent now due to the advent of therapies like ACE inhibitors, beta-blockers, and ARBs, but their utility remains established in guidelines. Side effects and tolerance (tachyphylaxis) can limit their long-term use. Overall, the evidence base is robust, though not as strong as for some newer agents, justifying a high but not maximal evidence score.
More about Nitrate (unspecified)
More about Congestive Heart Failure
Other ingredients used for Congestive Heart Failure
adenosine 5-triphosphate disodium (ATP)algal oil
arjun tree
astragalus
black garlic
coenzyme Q10 (CoQ10)
DHA (docosahexaeonic acid)
DPA (docosapentaenoic acid)
EPA (eicosapentaenoic acid)
fish oil
flavonols
garlic bulb
ginseng
hawthorn
l-arginine
l-carnitine
l-citrulline
l-taurine
marine lipid
n-acetyl-cysteine (NAC)
nicotinamide riboside
omega-3 fatty acids
ophiopogon root
potassium
resveratrol
thiamin (vitamin B1)
ubiquinol
vitamin D
zinc
β-nicotinamide mononucleotide (NMN)
AMP-activated protein kinase (AMPK)
Arjuna
Allicin
Arginine orotate
Astragaloside
Arjunic Acid
Black Seed
Chinese Silkvine
Catecholamine
Cowherb
Docosahexaenoic Acid
Danshen
Digitalis
Eicosapentaenoic Acid
Theophylline
Other health conditions supported by Nitrate (unspecified)
AnginaAthletic and Exercise Aids
Cardiovascular Disease
Chest Pain
Circulation (poor)
Circulation (to the brain)
Congestive Heart Failure
Exercise
Hypertension
Raynaud's Disease