Minoxidil in the management of moderate hypertension

The effects of minoxidil used in combination with propranolol were assessed in the management of moderate hypertension. All patients had diastolic blood pressures above 95 mm Hg after therapy with thiazide diuretics for 2 weeks and were randomly assigned to treatment schedules which added minoxidil and propranolol in dosage ratios of 1:2, 1:4, and 1:8. Diastolic pressures were reduced to less than 90 mm Hg by upward titration of minoxidil dosage while maintaining the appropriate ratio of propranolol. After 4 weeks at that dosage, minoxidil was discontinued: 2 weeks later propranolol was also withdrawn. A diastolic pressure less than 90 mm Hg was achieved with 5 mg of minoxidil in 50% of the patients. While vasodilator-induced tachycardia was blocked at all minoxidil/propranolol ratios, the 1:8 ratio group demonstrated the greatest percentage reduction in systolic and diastolic pressures at the end of the first week. We conclude that rapid control of moderate hypertension can be achieved by modest doses of minoxidil and with the production of only minor side effects, a minoxidil/propranolol ratio of 1:8 being adequate to prevent tachycardia.