MINOXIDIL IN THE MANAGEMENT OF INTRACTABLE HYPERTENSION

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 50  (198) , 175-190
Abstract
Patients [87] with intractable hypertension received minoxidil for a mean duration of 27 mo. (range 3 mo. to 5 yr). A significant reduction in mean outpatient blood pressure from 206/129 to 158/98 mmHg (P < 0.001 for both systolic and diastolic values) was recorded after 1 mo. treatment. In 26 patients who received minoxidil for 4 or more years a further reduction in mean blood pressure to 147/89 mmHg was achieved. The mean daily dose of minoxidil was 23 mg (range 2.5-60 mg). In all patients a .beta.-adrenergic neuron blocker and a diuretic were prescribed with minoxidil to counteract tachycardia and fluid retention. Patients [13] required the addition of a 4th hypotensive agent. The use of minoxidil led to simpler drug regimens with the majority of patients well controlled on twice daily or once daily schedules. Most patients commented spontaneously on a feeling of improved well being while taking minoxidil which also appeared to be relatively free from side effects commonly encountered with other hypotensive drugs, particularly drowsiness, dizziness and impotence. Fluid retention of 7 kg or more occurred in 18 patients, more commonly in those with renal impairment, but could be controlled by increasing the dose or potency of diuretics. Four patients with end stage renal failure and 1 patient with normal renal function developed pericardial effusions. Hirsutism was universal and limited the usefulness of the drug in women. Minoxidil is recommended for hypertensive men whose diastolic blood pressure remains .gtoreq. 110 mmHg despite an adequate trial of a .beta.-adrenergic neuron blocker, diuretic and an additional drug, or for patients who find the side effects of such therapy intolerable.