Hydralazine

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What is Hydralazine?

Hydralazine is a direct-acting vasodilator used to treat high blood pressure, particularly in cases where other medications haven't achieved adequate control or aren't appropriate—such as during pregnancy-related hypertension. It works by directly relaxing the smooth muscle in arterial walls, causing blood vessels to widen and blood pressure to drop. Because it acts so directly on blood vessels, it often causes reflex heart rate increases, which is why it's frequently combined with a beta-blocker. It's taken orally two to four times daily, and an IV form is used in hospital settings for hypertensive emergencies.

Direct arterial vasodilation

Relaxes smooth muscle in arteriolar walls through mechanisms that involve interference with calcium release and utilization, causing blood vessels to dilate and peripheral vascular resistance—and therefore blood pressure—to fall.

Pregnancy hypertension use

One of the few antihypertensives with a long safety record in pregnancy, making it a go-to option for managing hypertension in pregnant patients when beta-blockers or ACE inhibitors are not appropriate.

Reflex tachycardia consideration

The rapid blood pressure reduction triggers a compensatory reflex increase in heart rate—which is why Hydralazine is commonly paired with a beta-blocker to counteract this effect and improve tolerability.

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