Deleterious effects of hydralazine in patients with pulmonary hypertension

M. Packer, B. Greenberg, B. Massie, H. Dash

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Thirteen consecutive patients with primary and secondary pulmonary hypertension who had normal left ventricular function were treated with hydralazine in an effort to reduce pulmonary vascular resistance and clinical symptoms. Despite marked decreases in systemic vascular resistance (40 per cent; P<0.001) hydralazine produced only moderate decreases in pulmonary artery resistance (21 per cent), without improving stroke volume or pulmonary-artery pressure. Instead, mean arterial pressure fell markedly (17.5 mm Hg P<0.01) in association with a reflux increase in heart rate (11 beats per minute, P<0.01). Four patients became symptomatically hypotensive within 24 hours of the initiation of treatment; two of these four required pressors for circulatory support, and one died. Progressive renal insufficiency developed in one patient, and a symptomatic decrease in systemic arterial oxygen saturation occurred in another; both changes were reversed upon discontinuation of the drug. In conclusion, hydralazine fails to produce consistent hemodynamic and clinical benefits in patients with primary and secondary pulmonary hypertension, and it frequently causes serious adverse reactions.

Original languageEnglish (US)
Pages (from-to)1326-1331
Number of pages6
JournalNew England Journal of Medicine
Volume306
Issue number22
StatePublished - 1982

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Hydralazine
Pulmonary Hypertension
Vascular Resistance
Pulmonary Artery
Left Ventricular Function
Stroke Volume
Renal Insufficiency
Arterial Pressure
Heart Rate
Hemodynamics
Oxygen
Pressure
Pharmaceutical Preparations
Familial Primary Pulmonary Hypertension
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Packer, M., Greenberg, B., Massie, B., & Dash, H. (1982). Deleterious effects of hydralazine in patients with pulmonary hypertension. New England Journal of Medicine, 306(22), 1326-1331.

Deleterious effects of hydralazine in patients with pulmonary hypertension. / Packer, M.; Greenberg, B.; Massie, B.; Dash, H.

In: New England Journal of Medicine, Vol. 306, No. 22, 1982, p. 1326-1331.

Research output: Contribution to journalArticle

Packer, M, Greenberg, B, Massie, B & Dash, H 1982, 'Deleterious effects of hydralazine in patients with pulmonary hypertension', New England Journal of Medicine, vol. 306, no. 22, pp. 1326-1331.
Packer, M. ; Greenberg, B. ; Massie, B. ; Dash, H. / Deleterious effects of hydralazine in patients with pulmonary hypertension. In: New England Journal of Medicine. 1982 ; Vol. 306, No. 22. pp. 1326-1331.
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