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Abstract:
Minoxidil has been administered to 16 patients with severe hypertension and renal failure. In every patient the indication for minoxidil treatment was resistance to conventional drugs. The final dose of minoxidil was 2.5--30 mg (average 20) and it was combined with a beta-blocking agent and a diuretic (or dialysis). The therapy was given for 1--27 months (average 12). The average supine BP fell from 200/130 to 164/96 mmHg and the upright BP from 200/120 to 152/90 mmHg. No hypotensive reactions occurred. In most patients the progression of hypertensive organ changes was arrested. No major vascular complications have occurred during the 16 years of treatment. Prickling of the skin and hirsutism were common side-effects. The other side-effects observed were oedema in five patients and development of latent diabetes in three. In four patients minoxidil treatment was discontinued for following reasons: successful reconstruction of the renal artery after stenosis, renal transplantation, severe oedema and hirsutism. The risk of hirsutism is a contraindication to prolonged minoxidil administration in most femal patients. Minoxidil is especially indicated in uncontrolled renal hypertension.
Insights
Minoxidil effectively lowered blood pressure in patients with severe hypertension and renal failure resistant to other drugs. While side effects like hirsutism occurred, it arrested hypertensive organ damage and prevented major vascular events.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Severe hypertension with renal failure poses significant treatment challenges.
- Patients often exhibit resistance to conventional antihypertensive therapies.
- Minoxidil is a potent vasodilator considered for refractory cases.
Purpose of the Study:
- To evaluate the efficacy and safety of minoxidil in patients with severe hypertension and renal failure.
- To assess the impact of minoxidil on blood pressure control and hypertensive organ damage.
- To identify common side effects and contraindications for minoxidil use in this population.
Main Methods:
- Minoxidil was administered to 16 patients with severe hypertension and renal failure.
- Treatment was combined with beta-blockers and diuretics or dialysis.
- Patients were monitored for blood pressure changes, organ damage progression, and adverse events over an average of 12 months.
Main Results:
- Average supine blood pressure decreased from 200/130 to 164/96 mmHg; upright BP from 200/120 to 152/90 mmHg.
- Progression of hypertensive organ changes was arrested in most patients.
- Common side effects included skin prickling and hirsutism; edema and latent diabetes were also observed.
Conclusions:
- Minoxidil is an effective treatment for severe, drug-resistant renal hypertension.
- While side effects exist, minoxidil can halt hypertensive organ damage and prevent vascular complications.
- Hirsutism is a notable side effect, potentially contraindicating long-term use in female patients.