Jaeger P, Brunner H R, Turini G A, Jéquier E, Ferguson R K, Gavras H
Schweiz Med Wochenschr. 1978 Nov 4;108(44):1707-9.
Minoxidil-induced sequential changes in plasma renin activity, urinary aldosterone and norepinephrine excretion were assessed in 11 patients with severe hypertension receiving propranolol or oxprenolol, chlorthalidone and spironolactone. Blood pressure with this treatment alone averaged 175 +/- 7/114+/-4 mm Hg (mean +/- SEM). Addition of minoxidil in a dose of 5 to 35 mg/day (mean 16 mg/day) reduced blood pressure within one week to 125+/-5/87+/-3 mm Hg. Plasma renin, urinary aldosterone and norepinephrine increased two- to threefold initially, but returned to baseline within two weeks and remained unchanged during a mean follow-up of 6.8 months. In 6 patients beta-blocking drugs were then progressively reduced and withdrawn without adverse effects, though blood pressure and heart rate increased slightly in 5 patients who required readministration of minimal doses of beta-blockers. Neither renin nor urinary aldosterone or norepinephrine excretion changed significantly after discontinuation of beta-blockade. Thus, the stimulating effect of minoxidil on renin, aldosterone and norepinephrine secretion lasts less than 3 weeks. With long-term minoxidil treatment the need for beta-blockade is markedly reduced, and these drugs may even become unnecessary in some patients.
对11例重度高血压患者进行了评估，这些患者正在接受普萘洛尔或氧烯洛尔、氯噻酮和螺内酯治疗，观察了米诺地尔引起的血浆肾素活性、尿醛固酮和去甲肾上腺素排泄的序贯变化。仅采用这种治疗时，血压平均为175±7/114±4 mmHg（均值±标准误）。加用剂量为5至35 mg/天（平均16 mg/天）的米诺地尔，一周内血压降至125±5/87±3 mmHg。血浆肾素、尿醛固酮和去甲肾上腺素最初增加了2至3倍，但在两周内恢复至基线水平，并且在平均6.8个月的随访期间保持不变。随后，6例患者逐渐减少并停用β受体阻滞剂，未出现不良反应，不过5例需要重新服用最小剂量β受体阻滞剂的患者血压和心率略有升高。停用β受体阻滞剂后，肾素、尿醛固酮或去甲肾上腺素排泄均未发生显著变化。因此，米诺地尔对肾素、醛固酮和去甲肾上腺素分泌的刺激作用持续时间不到3周。长期使用米诺地尔治疗时，对β受体阻滞剂的需求显著减少，在某些患者中甚至可能不再需要这些药物。
