title: The efficacy and safety of intravenous hydralazine for the treatment of hypertension in the hospitalized child.
abstract: 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 <95th percentile for age, sex, and height after one dose. Seven (9 %) children had a documented AE. HR increased by a median of 3.5 %. In the multivariable models examining percentage change in systolic and diastolic BP, male gender was significantly associated with a change in systolic BP.
  
  
  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.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Department of Pharmacy, Cincinnati, OH, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Ostrye
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hailpern
authors.forename: Jenna
authors.initials: J
authors.lastname: Jones
authors.forename: Brent
authors.initials: B
authors.lastname: Egan
authors.forename: Katherine
authors.initials: K
authors.lastname: Chessman
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Shatat
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006760:Hospitalization; D006801:Humans; D006830:Hydralazine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D007275:Injections, Intravenous; D008297:Male; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D006830:Hydralazine