Minoxidil in the Management of Intractable Hypertension

In a study conducted 42 years ago, 87 patients with intractable hypertension were treated with minoxidil for an average of 27 months. The treatment resulted in a significant reduction in mean outpatient blood pressure from 206/129 to 158/98 mmHg after one month. In patients who received minoxidil for four 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. All patients were also prescribed a beta adrenergic neurone blocker and a diuretic to counteract tachycardia and fluid retention. Thirteen patients required an additional hypotensive agent. Most patients reported improved wellbeing while taking minoxidil, which appeared to be relatively free from common side effects of other hypotensive drugs. However, fluid retention of 7 kg or more occurred in 18 patients, and hirsutism was universal, limiting the drug's usefulness in women. The study recommended minoxidil for hypertensive men whose diastolic blood pressure remained greater than or equal to 110 mmHg despite other treatments, or for patients who found the side effects of other therapies intolerable.