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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Minoxidil in daily doses of 6 to 40 mg was administered to 11 patients with severe hypertension. Two patients died of causes unrelated to the drug and one patient withdrew from the study. Blood pressure was controlled in the remaining eight subjects, who received the drug for periods ranging from 5 to 40 months. In three patients minoxidil could subsequently be replaced by conventional antihypertensive therapy. Adverse effects of minoxidil included fluid retention (as assessed by edema and plasma volume studies), nonspecific ECG changes, hypertrichosis and conjunctival redness. Concomitant administration of diuretic and beta-adrenergic blocking agents resulted in excellent tolerance of the treatment and high patient compliance.
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PMID:Treatment of severe hypertension with minoxidil. 0 Mar 46

Resistant hypertension can be defined in terms of lack of blood pressure response to hypotensive agents, but there may be a big difference between standing and lying blood pressure levels. In general target organ damage and papilloedema improve if the standing blood pressure is controlled; however, progression can occasionally be documented when only the supine blood pressure remains uncontrolled. Resistant hypertension was a frequent phenomenon when ganglion blocking agents and hydrallazine were the only effective hypotensive agents. With the advent of the thiazides, effective control of the blood pressure became the exception rather than the rule; however, it was not until the advent of adrenergic blocking agents that reduction of supine blood pressures was regularly achieved. The addition of hydrallazine or prazosin to a combination of a thiazide and beta-adrenoreceptor blocking agent produces a further significant fall in the blood pressure lying and standing. This combination will control the blood pressure in most patients, but a few remain refractory to maximum doses and will require treatment with oral diazoxide or minoxidil. Both these powerful vasodilators are very effective in resistant hypertension. Oral diazoxide permits excellent control and allows a 10-fold reduction in the doses of other agents. Minoxidil usually needs to be combined with moderate doses of beta-blocking agents to reduce the marked reflex tachycardia. Only a 50% reduction in other hypotensive agents was achieved in patients treated with minoxidil and two patients proved resistant to minoxidil, but subsequently responded to oral diazoxide.
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PMID:The treatment of resistant hypertension. 0 54

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.
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PMID:Minoxidil in severe hypertension. 2 24

Minoxidil, a new peripheral vasodilator, given orally to hypertensive men in single doses of 5-25 mg, produced no haemodynamic changes within one hour after administration. After repeated oral doses within 24 hours to a total of 15-45 mg and after 10 mg t.i.d. orally for one week, moderate decreases in BP were seen concomitant with tendencies to increased heart rate and cardiac output. Clinically, oral minoxidil 10-50 mg daily in combination with diuretics and adrenergic beta-receptor blocking agents achieved an improved BP control in five patients with sustained arterial hypertension and unsatisfactory response to previous treatment. However, in four of the five patients minoxidil had to be withdrawn because of side-effects. It is concluded that minoxidil, producing a hypotensive effect of slow onset, may find a place as a therapeutic addition to symptomatic patients with severe and therapy-resistant hypertensive cardiovascular disease, provided adequate measures are taken to counteract side-effects, especially water retention and development of oedemas.
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PMID:Minoxidil--haemodynamic and clinical experiences with a new peripheral vasodilator. 23 65

Thirteen patients with advanced hypertensive disease insufficiently controlled by conventional drugs were treated with minoxidil in combination with a beta-blocking agent and a thiazide in a long-term study. A reduction from 214 +/- 5/122+/3 to 166 +/- 7/95 +/- 3 mm Hg in the mean supine blood pressure was obtained. The dosage range of minoxidil was 7.5-35 mg per day (mean 18.8 mg), and in all cases beta-blockade was necessitated by the occurrence of reflex tachycardia. Only two of the patients were found to be unsatisfactorily controlled on combined therapy. In five cases, minoxidil was disontinued during the observation period, but only in three cases was the discontinuation due to side effects, v.z. sodium retention and augmented hair growth. Stable diabetes developed in one patient, and in two cases of established, dietetically treated diabetes oral antidiabetic drugs had to be administered. Five non-diabetic patients showed no significant changes in fasting plasma glucose and the K values in intravenous glucose-tolerance tests. Minoxidil seems to be a safe and potent antihypertensive drug for long-term use in severe arterial hypertension, but it cannot be recommended for routine treatment.
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PMID:Long-term experiences with minoxidil in combination treatment of severe arterial hypertension. 30 92

Six children, from 1.3 to 18 years of age, with severe hypertension associated with the hemolytic uremic syndrome, periarteritis, and renal transplant rejection received minoxidil, an antihypertensive agent, for three to 36 weeks. All had severe hypertension resistant to oral antihypertensive medications; five required frequent intravenous diazoxide therapy prior to minoxidil therapy. The mean pretreatment systolic and diastolic blood pressures were 176 and 117 mm Hg, respectively. Following treatment, the mean systolic and diastolic blood pressures were 133 and 82 mm Hg, respectively. Concomitant antihypertensive medications were decreased in all six patients once optimal blood pressure control was obtained. The initial dosage of minoxidil was 0.1 to 0.2 mg/kg/day; maximal dosage for blood pressure was 0.3 to 1.4 mg/kh/day. Major complications of therapy were fluid retention and hirsutism. Transient asymptomatic pericardial effusions occurred in two patients. Three patients on prolonged minoxidil therapy had persistent increases in right ventricular end diastolic diameters. Minoxidil is an effective oral antihypertensive agent for treatment of severe hypertension in pediatric patients. Avoidance of fluid retention is mandatory to prevent congestive heart failure.
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PMID:Minoxidil therapy in children with severe hypertension. 32 42

Minoxidil was used to treat 26 patients (17 to 67 years old) with severe hypertension and varying degrees of renal function. Our object was to assess long-term clinical efficacy, kinetics (acute and chronic), and bioavailability of minoxidil in chronic renal insufficiency. Minoxidil, 27 to 30 mg per day, decreased systolic and diastolic blood pressure during the first three months of therapy. Between the third and 24th months (30 months in one patient) there was no further change. Propranolol or clonidine was needed to control heart rate, and furosemide or dialysis was needed to control edema induced by minoxidil. Renal function improved in some of the mildy azotemic patients. Minoxidil kinetics after the customary dose did not differ whether the drug was taken as tablet or solution. Kinetic parameters during chronic administration of minoxidil did not differ from those after acute administration. The kinetics in chronic renal insufficiency do not differ from these in subjects with normal renal function.
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PMID:Long-term clinical effects, bioavailability, and kinetics of minoxidil in relation to renal function. 36 64

Minoxidil, a new peripheral vasodilator, was used in the therapy of 26 hypertensives who were previously uncontrolled on conventional medications or who had dose-limiting side effects. Minoxidil provided (1) therapeutic advantages in all patients, regardless of the etiology of their hypertension, (2) no symptoms of orthostatic hypotension or sympathetic nervous system depression, (3) a simplification of medical regimens and perhaps costs, and (4) regression of impotence in four out of seven patients. The major limiting factors encountered were (1) fluid retention with the development of congestive heart failure in three patients, (2) pericardial effusion in three patients, and (3) hypertrichosis, which reduced its acceptability in female patients.
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PMID:Treatment of severe hypertension with minoxidil: advantages and limitations. 37 29

Minoxidil, a potent vasodilator antihypertensive agent, was given to 14 patients with severe hypertension uncontrolled by conventional agents. Thirteen patients had elevated serum creatinine levels. Over a period of 20 months (mean duration of administration) minoxidil lowered blood pressure from 194/124 to 147/90 mm Hg (mean values), in combination with furosemide and a sympathetic inhibitor (usually propranolol). Progression of preexisting renal disease was halted in all but three patients. Fluid retention, cardiac failure, and angina were troublesome side effects. The occurrence of hypertrichosis also limited the usefulness of minoxidil, particularly in female patients.
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PMID:Minoxidil therapy for refractory hypertension and chronic renal failure. 50 78

The blood pressure of 18 patients with refractory hypertension was controlled by treatment with Minoxidil in combination with Propranolol and diuretics. Ten of these patients were studied prospectively and were found not to have deterioration of carbohydrate tolerance while on Minoxidil therapy. Pericardial effusions occurred in 40% of the patients, including 2 with normal renal function. This untoward effect of prolonged use Minoxidil warrants further study.
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PMID:Minoxidil in refractory hypertension: benefits, risks. 60 Sep 67


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