Hydralazine hydrochloride has been recommended as a treatment for primary pulmonary hypertension. Two patients who were so treated experienced further elevation of the pulmonary artery pressure and clinical deterioration. The mechanism of this adverse effect was a decrease of systemic vascular resistance attended by an increase in cardiac output without a fall in the pulmonary vascular resistance. Hemodynamic monitoring is advised in patients undergoing vasodilator therapy for primary pulmonary hypertension.
Kronzon I, Cohen M, Winer HE. Adverse Effect of Hydralazine in Patients With Primary Pulmonary Hypertension. JAMA. 1982;247(22):3112–3114. doi:10.1001/jama.1982.03320470058033
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