Pediatric Nephrology

, Volume 29, Issue 8, pp 1403–1409 | Cite as

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

  • Julie Ostrye
  • Susan M. Hailpern
  • Jenna Jones
  • Brent Egan
  • Katherine Chessman
  • Ibrahim F. ShatatEmail author
Original Article



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.


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.


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.


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.


Elevated blood pressure Hydralazine Intravenous Hospitalized Pediatric Medication safety Drug therapy 


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Copyright information

© IPNA 2014

Authors and Affiliations

  • Julie Ostrye
    • 1
  • Susan M. Hailpern
    • 3
  • Jenna Jones
    • 4
  • Brent Egan
    • 5
  • Katherine Chessman
    • 2
  • Ibrahim F. Shatat
    • 6
    Email author
  1. 1.Cincinnati Children’s Hospital Medical CenterDepartment of PharmacyCincinnatiUSA
  2. 2.South Carolina College of PharmacyMedical University of South Carolina Children’s HospitalCharlestonUSA
  3. 3.Independent Epidemiology ConsultantSaratogaUSA
  4. 4.College of MedicineMedical University of South CarolinaCharlestonUSA
  5. 5.Care Coordination Institute, Greenville Health SystemUniversity of South Carolina School of MedicineGreenvilleUSA
  6. 6.Division of Nephrology and HypertensionMedical University of South Carolina Children’s HospitalCharlestonUSA

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