Related Experiment Videos
Clinical response of hypertensive children to long-term minoxidil therapy
Insights
Minoxidil effectively lowers blood pressure in children with severe hypertension, even when other drugs fail. However, hypertrichosis is a common side effect, resolving after treatment cessation.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Pharmacology
Background:
- Severe pediatric hypertension often requires multiple antihypertensive agents.
- Minoxidil is a potent vasodilator used for refractory hypertension.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of minoxidil in hypertensive children.
- To assess blood pressure reduction and adverse effects of minoxidil therapy.
Main Methods:
- 11 children with severe hypertension (BP > 99th percentile) received minoxidil for ≥ 6 months.
- Patients concurrently used propranolol and a diuretic (hydrochlorothiazide or furosemide).
- Minoxidil dosage ranged from 0.1-0.2 mg/kg/day, up to 5 mg/kg/24 hr.
Main Results:
- Significant blood pressure reduction was observed within 1 week of minoxidil initiation.
- Blood pressure remained significantly reduced throughout the study period.
- Hypertrichosis was a universal side effect, resolving within 3 months post-discontinuation.
- No other adverse reactions were reported.
Conclusions:
- Minoxidil is an effective antihypertensive agent for children with severe, treatment-resistant hypertension.
- Hypertrichosis is a predictable and reversible adverse effect of minoxidil in pediatric patients.
- Minoxidil can be considered for long-term management of severe pediatric hypertension when other therapies are insufficient.
Abstract:
The long-term effects of minoxidil were evaluated in 11 hypertensive children (5 male, 6 female) who used minoxidil for a minimum of 6 months. The selection of these patients for minoxidil therapy was made on the basis that their systolic and diastolic blood pressures were greater than the 99th percentile for aged-matched normals, despite their use of at least three other antihypertensive drugs. The starting daily dose of minoxidil was between 0.1 and 0.2 mg/kg, administered in two divided doses (maximum, 5 mg/kg/24 hr). They also received propranolol and either hydrochlorothiazide or furosemide throughout the period of study. A significant reduction in blood pressure was noted 1 week after starting minoxidil. Although blood pressure continued to decrease during the following 2 weeks in association with an increase in minoxidil dosage, the levels of blood pressure recorded throughout the remainder of the period of evaluation did not differ significantly from the values at 1 week. All children developed hypertrichosis over the overhead, trunk, and extremities, regardless of drug dosage. This remitted in all cases within 3 months after minoxidil was discontinued. No other adverse reactions were observed.