Mitchell H C, Pettinger W A
JAMA. 1978 May 19;239(20):2131-8.
Twenty-nine hypertensive patients refractory to conventional medications were treated continuously with minoxidil, sympathetic suppressants, and diuretics for six months to five years (mean, 30 months). All had evidence of hypertensive end-organ damage before minoxidil therapy. Good blood pressure control was obtained in 21 (72%) of 29 patients when minoxidil was given in dosages up to 40 mg/day. No tolerance was found. In the remaining eight, good control was obtained in three when phenoxybenzamine therapy was added, and in one when clonidine therapy was added. Renal failure requiring hemodialysis developed in five of 29, one had temporary hemiparesis, and one had fatal cerebral hemorrhage. In the remainder, myocardial infarctions and strokes were effectively prevented. Patients receiving minoxidil and propranolol hydrochloride had elevated plasma norepinephrine levels while those receiving clonidine had normal plasma norepinephrine levels.
29名对常规药物治疗无效的高血压患者连续使用米诺地尔、交感神经抑制剂和利尿剂治疗6个月至5年（平均30个月）。所有患者在米诺地尔治疗前均有高血压靶器官损害的证据。当米诺地尔剂量高达40mg/天时，29例患者中有21例（72%）血压得到良好控制。未发现耐受性。其余8例中，加用酚苄明治疗的3例和加用可乐定治疗的1例血压得到良好控制。29例中有5例发生需要血液透析的肾衰竭，1例出现短暂性偏瘫，1例发生致命性脑出血。其余患者的心肌梗死和中风得到有效预防。接受米诺地尔和盐酸普萘洛尔治疗的患者血浆去甲肾上腺素水平升高，而接受可乐定治疗的患者血浆去甲肾上腺素水平正常。
