The efficacy and safety of intravenous hydralazine for the treatment of hypertension in the hospitalized child

Background Intravenous (IV) hydralazine is frequently used for the treatment of elevated blood pressure (BP) in hospitalized children. Its safety and efficacy have not been examined. Methods This is a retrospective chart review of IV hydralazine use in hospitalized children (birth to 17 years) over a 3 year period. Demographic data and data on adverse effects (AE), BP, and heart rate (HR) prior to and after each first dose were collected. Results The patient cohort comprised 110 children admitted to the hospital during the study period, of whom 77 received the recommended dose. Mean age of the children was 8.5 ± 5.4 years; 33% were male, and 32.5% were white. Pre-dose systolic and diastolic BP indexes were 1.3 and 1.2, respectively. The median reduction in systolic and diastolic BP was 8.5 and 11.5%, respectively. Sixteen (21%) children achieved a 25% reduction in systolic or diastolic BP, and BP increased in 30% of patients; 10% of children had a BP of Conclusions In hospitalized children, IV hydralazine was well tolerated, BP response was variable, and 21% of the patients achieved a ≥ 25% reduction of systolic or diastolic BP. Further studies are needed to compare the safety and efficacy of IV hydralazine to other short-acting antihypertensive agents. Keywords Elevated blood pressure Hydralazine * Intravenous * Hospitalized * Pediatric * Medication safety * Drug therapy
Background Blood pressure (BP) in children is categorized based on the patient's age, sex, and height. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) below the 90th percentile for [...]