Side Effects of hydralazine: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Hydralazine is an oral medication commonly used to treat pregnancy-associated hypertension. 4 Hydralazine is known to have a vasodilating effect, lowering blood pressure. 21 However, hydralazine can cause side effects, including those that affect the immune system. 6

Reasons for Side Effects

Hydralazine's side effects can be divided into two categories: extension of the pharmacological effect and immune response. 4 Extension of the pharmacological effect includes blood pressure reduction due to vasodilation, headache, nausea, flushing, hypotension, palpitations, tachycardia, dizziness, and salt retention. 4 Immune response is most commonly drug-induced lupus-like syndrome. 4 Hydralazine has also been reported to affect the liver, lungs, and kidneys. 1 7 9

Common Side Effects

Extension of the Pharmacological Effect

Headache, nausea, flushing, hypotension, palpitations, tachycardia, dizziness, and salt retention 4

Drug-induced Lupus-like Syndrome

Fever, joint pain, muscle pain, skin rash, kidney damage, blood abnormalities 6 23

Effects on the Liver

Liver dysfunction, liver inflammation 1

Effects on the Lungs and Kidneys

Lung inflammation, kidney inflammation 7 9

Side Effect Countermeasures

Extension of the Pharmacological Effect

Adjust the dosage of hydralazine 4

Drug-induced Lupus-like Syndrome

Discontinue hydralazine 6

Effects on the Liver

Perform regular liver function tests 1

Effects on the Lungs and Kidneys

Perform regular lung and kidney function tests 7 9

Comparison Between Studies

Commonalities in Studies

Most studies have shown that hydralazine is effective in treating pregnancy-related hypertension. 25 11 8 20 It is also common that hydralazine can cause side effects. 4 6 1 23 7 9

Differences in Studies

The type and frequency of hydralazine's side effects vary depending on the study. 4 6 1 23 7 9 Also, the effectiveness of hydralazine can vary depending on the study. 25 11 8 20

Precautions for Real-life Application

Hydralazine is an effective drug for treating pregnancy-related hypertension, but it can cause side effects. 4 6 1 23 7 9 It is important to follow your doctor's instructions and watch for signs of side effects when using hydralazine. 19

Current Research Limitations

Research on the side effects of hydralazine is still insufficient. 19 In particular, there is not enough data on the effects of long-term use of hydralazine. 19

Future Research Directions

Further research on the side effects of hydralazine is needed. 19 In particular, detailed studies on the effects of long-term use are needed. 19 Also, further research on the interactions of hydralazine with other drugs is necessary. 19

Conclusion

Hydralazine is an effective drug for treating pregnancy-related hypertension, but it can cause side effects. 4 6 1 23 7 9 It is important to follow your doctor's instructions and watch for signs of side effects when using hydralazine. 19 Further research on the side effects of hydralazine is needed. 19

Keywords
Benefit Keywords
Treatment of autoimmune diseases
3
Antitumor effects
Tumor suppressor gene reactivation
4
Hypertension treatment
5
Infection treatment
Pain management
Sedation
8
Least side effects
9
Cardiac output increase
Hydralazine effectiveness
Hydralazine increases cardiac output
Increased cardiac output
12
Prevents complications
Reduces perinatal death
13
Heart failure treatment
Reduced hospitalizations
Reduced mortality
14
BP reduction
Oral agents
16
Reduces BP
17
ECT for depression
Reduced cardiovascular risks with ECT
18
Effective BP control
20
Reduced blood pressure
21
Cancer treatment
22
Hypertension treatment
Preeclampsia treatment
25
Risk Keywords
Liver injury
1
Autoimmune disease
2
Drug-induced lupus
3
Myelosuppression
Side effects
4
Adverse effects
Unexpected interactions
5
Autoimmune disease
Drug-induced lupus
6
High mortality risk
Lupus
Pulmonary-renal syndrome
Vasculitis
7
Congenital malformations
Fetal risk
8
ANCA-positive pauci-immune GN
Drug-induced vasculitis
9
Hypotension
Myocardial infarction
Nausea
Syncope
Tachycardia
10
Postpartum hypertension
Side effects
11
Acute side effects
Hydralazine effects
Hydralazine side effects
Side effects
12
Growth retardation
Long-term infant effects
Placental hypoperfusion
13
Hyperkalemia
14
Heart failure
15
Maternal mortality
Stroke
16
Hydralazine toxicity
Nifedipine toxicity
Nitroglycerin toxicity
Sodium nitroprusside toxicity
17
Avoid ECT in urgent cardiovascular surgery
Cardiovascular complications
18
Epigenetic side effects
19
Hypotension
21
Acrolein toxicity
CAA toxicity
22
Drug-induced lupus
23
Lupus nephritis
24
Fetal side effects
25
Body composition changes
26
Literature analysis of 26 papers
Positive Content
11
Neutral Content
3
Negative Content
12
Article Type
2
0
1
11
25
1.

Hydralazine-induced liver injury: a review and discussion.

Author: BhardwajMeeta, BhardwajNakul Jay, CuetoKendra, KilleenT Colin

Liver injury

This case report highlights a patient who developed hydralazine-induced liver injury, characterized by non-specific symptoms and a hepatocellular injury pattern. After discontinuing hydralazine, liver enzymes normalized, and symptoms resolved within 3 weeks. This case emphasizes the need for close monitoring of liver enzymes in patients taking hydralazine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Primer: epigenetics of autoimmunity.

Author: RichardsonBruce

Autoimmune disease

Epigenetic mechanisms, such as DNA methylation, may play a role in the development of autoimmune diseases like SLE, influenced by both genetic and environmental factors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

A review on the clinical pharmacokinetics of hydralazine.

Author: Shahzad QamarAsma, ZamirAmmara, KhalidSundus, AshrafWaseem, ImranImran, HussainIltaf, RehmanAnees Ur, SaeedHamid, MajeedAbdul, AlqahtaniFaleh, RasoolMuhammad Fawad

Hypertension treatment
Adverse effects
Unexpected interactions

Hydralazine is a vasodilator used to treat hypertension, preeclampsia, and heart failure. Understanding its clinical pharmacokinetics helps clinicians optimize dosage and frequency to minimize adverse effects and potential life-threatening interactions.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Drugs and autoimmunity--a contemporary review and mechanistic approach.

Author: ChangChristopher, GershwinM Eric

Autoimmune disease
Drug-induced lupus

Drug-induced autoimmunity can be caused by various mechanisms, including altered gene transcription, cytokine imbalance, and tolerance breakdown. Although many drugs can induce autoantibodies, only a few are strongly linked to autoimmune diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Hydralazine-Induced ANCA Associated Vasculitis (AAV) Presenting with Pulmonary-Renal Syndrome (PRS): A Case Report with Literature Review.

Author: DoughemKarim, BattishaAyman, SheikhOmar, KonduruLakshmi, MadoukhBader, Al-SadawiMohammed, ShaikhShakil

High mortality risk
Lupus
Pulmonary-renal syndrome
Vasculitis

Hydralazine, a medication for hypertension and heart failure, can cause rare but serious side effects like hydralazine-induced lupus and ANCA-associated vasculitis, potentially leading to a life-threatening condition called pulmonary-renal syndrome. Early diagnosis and treatment are crucial.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Hydralazine-induced pauci-immune glomerulonephritis: intriguing case series with misleading diagnoses.

Author: BabarFaizan, PosnerJeffery N, ObahEugene A

Least side effects
ANCA-positive pauci-immune GN
Drug-induced vasculitis

This abstract presents two cases of ANCA-positive pauci-immune glomerulonephritis potentially caused by hydralazine, a hypertension medication. It also reviews the pathogenesis of drug-induced vasculitis and outlines diagnostic and treatment strategies to minimize adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Electrocardiographic Changes Following Acute Hydralazine Overdose.

Author: VahabzadehMaryam, EshraghiAli, Akbari-RadMina, FirooziAbdollah, EsmaeiliAlireza, AhrariYaghoub

Hypotension
Myocardial infarction
Nausea
Syncope
Tachycardia

Hydralazine overdose can cause severe symptoms, including dangerously low blood pressure, fast heart rate, and nausea. A case report highlights a young woman who experienced a heart attack after a hydralazine overdose, demonstrating the potential for serious cardiovascular complications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Clonidine versus captopril for treatment of postpartum very high blood pressure: study protocol for a randomized controlled trial (CLONCAP).

Author: Noronha-NetoCarlos, KatzLeila, CoutinhoIsabela C, MaiaSabina B, SouzaAlex Sandro Rolland, AmorimMelania Maria Ramos

Postpartum hypertension
Side effects

There's limited evidence on the best treatment for postpartum hypertension. While some drugs like captopril are effective, they can have side effects. More research is needed, especially on newer medications like clonidine, to determine the optimal treatment for this condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Importance of internal controls, statistical methods, and side effects in short-term trials of vasodilators: a study of hydralazine kinetics in patients with aortic regurgitation.

Author: McKayC R, NanaM, KawanishiD T, ElkayamU, ChandraratnaP A, WeissJ N, RahimtoolaS H

Cardiac output increase
Hydralazine effectiveness
Hydralazine increases cardiac output
Increased cardiac output
Acute side effects
Hydralazine effects
Hydralazine side effects
Side effects

Hydralazine increased cardiac output in patients with aortic regurgitation, but more frequent dosing led to higher rates of side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Report of the Canadian Hypertension Society Consensus Conference: 3. Pharmacologic treatment of hypertensive disorders in pregnancy.

Author: ReyE, LeLorierJ, BurgessE, LangeI R, LeducL

Prevents complications
Reduces perinatal death
Growth retardation
Long-term infant effects
Placental hypoperfusion

For pregnant women with severe hypertension (systolic blood pressure > 169 mm Hg or diastolic pressure > 109 mm Hg), immediate pharmacologic treatment with hydralazine, labetalol, or nifedipine is recommended. Other hypertension thresholds and first-line medications are provided in the guidelines.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
GuidelineRecommendations and best practices developed by experts for healthcare professionals to refer to when making clinical judgments and providing care.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Practice GuidelineGuidelines and recommendations for the diagnosis and treatment of specific medical conditions in medical practice.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

A review of heart failure treatment.

Author: GuyattGordon H, DevereauxP J

Heart failure treatment
Reduced hospitalizations
Reduced mortality
Hyperkalemia

Heart failure has high mortality rates (10-40%). ACE inhibitors and beta-blockers are effective in reducing mortality, while spironolactone helps reduce mortality in patients with severe heart failure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Hydralazine combined with conventional therapy improved outcomes in severe systolic dysfunction and mitral regurgitation.

Author: HsiaoShih-Hung, HsiaoChao-Sheng, ShiauJau-Wen, ChiouKuan-Rau

Heart failure

The study explored the potential benefits of early hydralazine up-titration in patients with heart failure and severe mitral regurgitation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

[Electroconvulsive therapy and aortic aneurysm: apropos of a case].

Author: Attar-LevyD, FidelleG, BrochierP, Van SteenbrugeL, LôoH

ECT for depression
Reduced cardiovascular risks with ECT
Avoid ECT in urgent cardiovascular surgery
Cardiovascular complications

This case report concerns an 89 year old woman with melancholic depression and an aortic aneurysm who was successfully treated with electroconvulsive therapy (ECT).

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

20.

Efficacy of nifedipine versus hydralazine in the management of severe hypertension in pregnancy: A randomised controlled trial.

Author: AdebayoJoshua Adeniyi, NwaforJohnbosco Ifunanya, LawaniLucky Osaheni, EsikeChidi Ochu, OlaleyeAyodele Adegbite, AdieleNnabugwu Alfred

Effective BP control

Oral nifedipine and intravenous hydralazine showed comparable efficacy in controlling blood pressure in pregnant women with severe hypertension. Nifedipine required fewer doses to achieve target blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Drugs for rapid treatment of very high blood pressure during pregnancy.

Author: DuleyL, Henderson-SmartD J

Reduced blood pressure
Hypotension

Diazoxide and ketanserin are not recommended for severe hypertension during pregnancy. Further research is needed to compare other antihypertensive agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Acrolein and chloroacetaldehyde: an examination of the cell and cell-free biomarkers of toxicity.

Author: MacAllisterStephanie L, Martin-BrisacNicolas, LauVincent, YangKai, O'BrienPeter J

Cancer treatment
Acrolein toxicity
CAA toxicity

Acrolein and CAA, metabolites of cancer drugs cyclophosphamide and ifosfamide, can cause toxicity through various mechanisms. Acrolein was found to be more potent than CAA in causing toxicity, and reducing agents were the most effective protective agents against both. Understanding these pathways of toxicity could help develop strategies to mitigate side effects in cancer treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Severe hydralazine-induced lupus presenting as systemic lupus erythematosus.

Author: RubinR L, HaluptzokR F, DavilaL M

Drug-induced lupus

This case study highlights the challenges of diagnosing drug-induced lupus. Delayed diagnosis can lead to worsened symptoms, emphasizing the importance of considering drug-related causes for lupus-like symptoms.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Hydralazine-Induced Isolated Lupus Nephritis.

Author: KhanNaseer, ReichelRonald, KhurshidAyesha, TsoKatie, BroussardJoan, DassAmrika

Lupus nephritis

Hydralazine can cause lupus nephritis, a kidney condition. A 79-year-old man developed this after taking hydralazine for hypertension. Stopping the drug and using immunosuppressants led to a full recovery.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

25.

Drug management of hypertensive disorders of pregnancy.

Author: KhedunS M, MoodleyJ, NaickerT, MaharajB

Hypertension treatment
Preeclampsia treatment
Fetal side effects

This article reviews drugs used to manage hypertension in pregnancy and the preeclampsia-eclampsia syndrome. While older, established drugs remain effective, newer options, particularly calcium antagonists, show promise with fewer side effects. However, the long-term safety of these newer drugs for both mother and fetus still requires further investigation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

Hydralazine treatment alters body composition in the rabbit model of obesity.

Author: CarrollJoan F, KingJeffrey W, CohenJoshua S

Body composition changes

Hydralazine's side effects, including tachycardia, edema, and nausea, may affect body composition by increasing body water or reducing body fat.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

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