| Objectives: To assess the effect and safety of nitrates in the treatment of patients with chronic heart failure.Method: We searched randomized controlled trials via the Cochrane Central Register of Controlled Trials, CENTRAL ISSUE 2, 2006,MEDLINE( 1966 -2006 ),EMBASE( 1974-2006 ),Cochrane Library (ISSUE 2, 2006),CBM and CNKI ( 1980-2006). We evaluated the quality of included randomized controlled trial and performed the meta-analysis by RevMan 4.2.7.Main Results: Seven trials were included involving 600 patients (315 patients in the treatment group and 285 patients in the control group). The results of meta-analysis indicated that improvement of exercise tolerance in nitrates group were superior compared with placebo group ((WMD 57.00, 95%CI 23.43-90.57). However, the results of deaths, worsening of heart failure, hospitalization showed no statistical significance between groups ((RR 1.53, 95%CI 0.66-3.53; RR0.99, 95%CI 0.66-1.48; RR1.11, 95%CI 0.54-2.30). In addition, nitrates improved the quality of life (WMD 4.00, 95%CI 0.35-7.65).This review indicated that the result of adverse effects showed no statistical significance between groups (RR1.14,95%CI 0.76—1.71).Conclusion: The present evidence indicated that nitrates could improve exercise tolerance. However, because of the limited numbers of trials with small sample sizes, we could not come to a firm conclusion on the effect of nitrates for chronic heart failure.
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