Abstract

The hydrazinophthalazines-derivates (syn. hydrazine) hydralazine and dihydralazine were approved by the FDA as anti-hypertensives in 1953 – and because they are both effective and safe they are among the oldest drugs which have kept their place in clinical practice. While hydrazine was originally discovered as potent vasodilatator which lowered blood pressure and increased renal perfusion, it received renewed recognition in the 1980s due to its effectiveness for the treatment of heart failure and further reconsideration in the 2000s due to its effectiveness to reverse epigenetic DNA methylation in cancer. In light of recent advances in the understanding of cardio-renal interactions and contribution of epigenetics to chronic heart and kidney failure, we here re-visit rationales for use of hydrazine in clinical care.