Drug Safety

, Volume 11, Issue 2, pp 80–85 | Cite as

Adverse Effects of Direct-Acting Vasodilators

  • Pedro Armario
  • Raquel Hernandez del Rey
  • Helios Pardell
Review Article Drug Experience


Direct-acting vasodilating agents enter the vascular smooth muscle cell to cause vasodilatation. For long term treatment of hypertension, the use of these drugs as monotherapy is accompanied by activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system. These counteracting mechanisms limit the antihypertensive efficacy of these drugs, and cause adverse effects such as tachycardia and fluid retention. These adverse effects require treatment with β-blockers and diuretics. However, there is still an important role for intravenous vasodilator therapy in hypertensive emergencies.

In the treatment of chronic heart failure, vasodilator therapy has been an important advance. Combination therapy with hydralazine and nitrates is efficacious in improving survival, but ACE inhibitors have an incremental benefit on survival over this combination.


Adis International Limited Sodium Nitroprusside Hydralazine Diazoxide Minoxidil 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Pedro Armario
    • 1
  • Raquel Hernandez del Rey
    • 1
  • Helios Pardell
    • 1
  1. 1.Hypertension Unit, Department of Internal MedicineRed Cross HospitalHospitalet de Llobregat, BarcelonaSpain

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