Long-term treatment of refractory hypertensive patients with minoxidil
H. C. Mitchell and W. A. Pettinger
Twenty-nine hypertensive patients refractory to conventional medications
were treated continuously with minoxidil, sympathetic suppressants, and
diuretics for six months to five years (mean, 30 months). All had evidence
of hypertensive end-organ damage before minoxidil therapy. Good blood
pressure control was obtained in 21 (72%) of 29 patients when minoxidil was
given in dosages up to 40 mg/day. No tolerance was found. In the remaining
eight, good control was obtained in three when phenoxybenzamine therapy was
added, and in one when clonidine therapy was added. Renal failure requiring
hemodialysis developed in five of 29, one had temporary hemiparesis, and
one had fatal cerebral hemorrhage. In the remainder, myocardial infarctions
and strokes were effectively prevented. Patients receiving minoxidil and
propranolol hydrochloride had elevated plasma norepinephrine levels while
those receiving clonidine had normal plasma norepinephrine levels.
