Objective: To evaluate drug therapy in hospitalized patients with heart failure and effect of guidelines for management of chronic heart failure on clinical practice.Methods: All patients were admitted in hospital in 1998~1999(as A groups), in 2000~2001 year(as B groups)and in 2002-2003year (as C groups).Results: ①A total of 1025 patients with heart failure were enrolled. The ratio of man with woman was 1.3:1. The average age was 63.8 ± 15.3 years. The patients with heart function of level Ⅲ and Ⅳ were 51.5% in the total patients. There was no distinct difference of the general condition in the three groups (P>0.05)②Common causes of heart failure were primary hypertension(31.0%). Coronary heart disease(29.7%)andrheumatic valvular heart disease(18.6%). ?The diuretics> digitalis and nitrates still dominated the drug therapy in hospital, with the total proportion of 54.4%, 52.7%, 49.0%, respectively. The user of angiotensin converting enzyme inhibitor(ACEI) was 51.5%. The user of P-blocker was 24.0%. The adminstration of |3-blocker and angiotensin II receptor blocker were increased from 20.2% and 1.6% to 27.2% and 10.0% respectively(P<0.01).The user of nitrates was decreased from 56.0% to 28.8%(P<0.01).Conclusions: There is a great gap between optimal medical strategy and clinical practice in the management of heart failure. The study suggest that greater efforts are required to improve training and clinical pratice of primary care teams in the management of heart failure.