Minoxidil was used in 25 patients with severe
hypertension whose blood pressure (BP) could not be controlled with conventional treatment or who suffered from intolerable side effects during treatment with other drugs. In 6 patients
minoxidil was withdrawn after a short time owing to side effects or because
hypertension could be controlled by regular dialysis treatment. The remaining 19 patients were treated with
minoxidil for 0.5-4.5 years. The hypotensive effect of
minoxidil in combination with beta-blockers and
diuretics was good or acceptable in all patients. Neither
orthostatic hypotension nor development of resistance was observed.
Minoxidil was well tolerated in one patient with
porphyria and in two patients who have had the
hydralazine syndrome. Eighteen patients had
kidney failure with elevated serum
creatinine. With one exception the uraemia progressed if the serum
creatinine level was above 300 mumol/litre at the start of the treatment. All patients tended to develop oedema, but this was controlled by concomitant
diuretic therapy. Eighteen patients developed
hypertrichosis. No other significant side effects were observed. One patient died and two patients developed
pericarditis in the highly uraemic phase in connection with the start of dialysis. Neither the death nor the cases of
pericarditis can be attributed to
minoxidil.
Minoxidil was found to be effective in severe
hypertension in connection with advanced renal disease and can be considered as a valuable addition to the established therapeutic arsenal for treatment of severe
hypertension.