1. 99.9999% of hydralazine prescriptions are written for high blood pressure by those who take the path of least resistance
2. Hydralazine is also bad when people develop vasculitis from it
Looked up the list of most common drug causes of vasculitis. Lots of these are commonly used 😬! What lab workup would you do first if you suspected drug-induced vasculitis?
OK. HTN guidelines do not recommend hydralazine as 1st or 2nd line and adherence is challenging. But HFrEF guidelines do for persistent HFrEF despite ARNI/BB/MRA.
Yes... the problem is that people want the path of least resistance: it blows to see people without HFrEF and kidney disease being on 100+ mg of this worthless for HTN POS instead of literary anything else in the planet
And in pregnancy? Until we stop excluding pregnant women from the majority of drug trials they will be limited to the dirty old stuff considered terrible for everyone else.
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2. Hydralazine is also bad when people develop vasculitis from it