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Hydralazine once daily in hypertension
British Medical Journal (Clinical Research Ed.)
|May 29, 1982
Summary
Conventional hydralazine is effective twice daily for hypertension. Once-daily dosing, even with slow-release formulations, showed waning effects, particularly in rapid acetylators.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Clinical Pharmacy
Background:
- Hypertension management often involves multiple medications.
- Hydralazine is a vasodilator used in treating hypertension.
- Optimizing hydralazine dosing and formulation is crucial for sustained blood pressure control.
Purpose of the Study:
- To evaluate the impact of hydralazine formulation and dosing frequency on blood pressure control.
- To compare conventional and slow-release hydralazine administered once or twice daily.
- To assess the influence of acetylator status on hydralazine efficacy.
Main Methods:
- A double-blind, randomized crossover study involving 20 hypertensive patients.
- Four treatment regimens were tested: placebo, conventional hydralazine BID, conventional hydralazine QD, and slow-release hydralazine QD.
- Blood pressure and pulse rate were measured at peak and trough intervals.
Main Results:
- All hydralazine regimens significantly reduced blood pressure compared to placebo.
- Once-daily conventional hydralazine provided inadequate control, with diminished effects at 24 hours.
- Twice-daily conventional and once-daily slow-release hydralazine offered 24-hour control, with greater effects in slow acetylators.
Conclusions:
- Hydralazine does not require administration more than twice daily for effective hypertension management.
- Slow-release hydralazine and conventional hydralazine twice daily provide sustained 24-hour blood pressure control.
- Acetylator phenotype influences the magnitude of hydralazine's hypotensive effect.