Combined treatment with minoxidil and captopril in refractory hypertension

The BP of four patients with severe hypertension could not be controlled by treatment with a variety of drugs including minoxidil and captopril. Satisfactory responses were obtained only when minoxidil and captopril were given in combination (along with diuretic and beta-adrenergic blocking agents). The doses of minoxidil could be reduced by the addition of captopril and adverse effects were thus minimized. The state of the renin-angiotensin system prior to therapy was not a reliable predictor of the hypotensive response of the combination.