Hazards in treatment of systolic hypertension

Eight patients with arteriosclerotic systolic hypertension whose blood pressure had been nonresponsive to conventional antihypertensive therapy, were given minoxidil in daily doses of 4 to 15 mg. Within 2 to 5 days the blood pressure of seven patients was brought to more "normal" levels. After 10 to 20 days of treatment, a significant weight increase was observed with a concomitant rise of blood pressure, which could be overcome by more vigorous diuretic therapy. However, six of the seven blood pressure responders and the one nonresponder complained of severe adverse effects curtailing further use of the drug. It is concluded that despite the effectiveness of arteriolar vasodilation in the reduction of elevated systolic blood pressure, such lowering may be deleterious in patients with atherosclerotic involvement of vital organs.