Persistent Reversal of Severe Systemic Hypertension after Prolonged Toxic Reaction to Hydralazine

Abstract

A patient with severe progressive hypertension was treated with parenteral hexamethonium and large dosages of hydralazine. He developed a ‘hydralazine syndrome’, the etiology of which was not recognized for approximately 9 months. Upon discontinuance of hydralazine the patient was easily kept normotensive for over 20 years, using only small dosages of cryptenamine, reserpine and/or bendro-flumethiazide. Similar observations are cited in the literature in seven other patients who were treated with hydralazine for significant periods of time after toxic symptoms occurred.