A Comparison of Minoxidil and Hydralazine in Non-Azotemic Hypertensives

    June 1983 in “ Journal of Hypertension ”
    Brian F. G. Johnson, Henry R. Black, R. M. Beckner, Bonnie H. Weiner, Fran Angeletti
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    TLDR Minoxidil lowers blood pressure more effectively but has more side effects, so try hydralazine first.
    This study compared the effectiveness and side effects of two vasodilators, minoxidil and hydralazine, in non-azotemic hypertensive patients. The study found that minoxidil was more effective in reducing blood pressure, but also caused more adverse effects such as weight gain, oedema, and hypertrichosis (increased body hair growth). Hydralazine produced a greater additional fall in blood pressure 2-4 hours after a dose was ingested, but had diurnal variability. The study suggests that hydralazine should be tried first as a Step 3 agent in non-azotemic hypertensives who are incompletely controlled by a diuretic and beta-blocker combination.
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