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Although the mechanism is not completely understood, it is theorized to be associated with intracellular calcium homeostasis. Hydralazine is subject to polymorphic acetylation 16 slow acetylators generally have higher plasma levels of hydralazine and require lower doses to maintain control of pressure. It acts directly on vascular smooth muscle, causing arterial dilation and thereby reducing both afterload and cardiac workload
Its rapid onset and efficacy make it valuable in acute hypertensive crises and chronic therapy. Hydralazine is a medication primarily used to treat high blood pressure (hypertension) and heart failure It works by relaxing blood vessels, making it easier for the heart to pump and for blood to flow. This represents a novel mechanism of action for hydralazine and presents hif as a potential target for treatment of ischemic disease.
The drug causes activation of the sns and of the raas system, resulting in tachycardia, increased cardiac output, and sodium retention. Hydralazine acts by dilating resistance arterioles, thus reducing peripheral resistance.
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