Treatment of refractory hypertension with minoxidil.

Twenty patients with hypertension refractory to conventional therapy were treated with minoxidil in combination with a diuretic and a beta-blocker. The mean supine initial blood pressure was 207/128 mm Hg, and the end-treatment pressure was 155/89 mm Hg. Five of the 7 patients with essential hypertension were adequately controlled, as were 8 of the 9 patients with renal failure and all 4 patients with renovascular hypertension. Thus, the overall controll rate was 85%. The duration of treatment ranged from 1 to 30 months, and the minoxidil dosage ranged from 5 to 60 mg/dry electrocardiographic changes characterized by T-wave inversion after starting minoxidil. These changes were reversible in 4 patients. Minoxidil was found to be an effective antihypertensive drug in these patients with refractory hypertension.