Vasodilators currently prescribed in the treatment of congestive heart failure represent a wide class of drugs. In acute heart failure, the therapeutic choice should be based on considerations about the mechanisms of drug action as well as the site of action on the vascular bed, together with the patient's hemodynamic and clinical characteristics. For medium-to long-term treatment the choice should be oriented towards drugs which do not activate compensatory or feedback regulation mechanisms. Use of therapeutic agents such as inhibitors of the angiotensin converting enzyme will avoid the development of physiological tolerance.