Hydralazine is a vasodilator that works primarily by increasing cGMP (cyclic guanosine monophosphate) levels in smooth muscle cells, leading to their relaxation. It preferentially dilates arterioles more than veins, resulting in a significant reduction in afterload. This action is particularly effective in conditions involving high blood pressure or heart failure.
Hydralazine is commonly used in the following clinical situations:
Additionally, hydralazine is frequently co-administered with a β-blocker to mitigate the reflex tachycardia that can result from its vasodilatory effects.
While effective, hydralazine can cause several side effects, including:
| Adverse Effect | Clinical Significance |
|---|---|
| Compensatory tachycardia | Can worsen angina or coronary artery disease (CAD), making it contraindicated in these conditions. |
| Fluid retention | Can lead to edema, often requiring diuretic therapy. |
| Headache | A common side effect due to vasodilation. |
| Angina | May exacerbate angina due to reflex tachycardia. |
| Drug-induced lupus | An autoimmune reaction presenting as joint pain, rashes, or other systemic symptoms. |
Adverse effects include compensatory tachycardia (contraindicated in angina/CAD), fluid retention, headache, angina, and drug-induced lupus.
Hydralazine is used to treat severe hypertension and heart failure, especially when combined with nitrates.
It reduces afterload and dilates arterioles more than veins.
Coadministration with β-blockers is common to prevent reflex tachycardia.
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