Minoxidil for Treatment of Resistant Hypertension in Chronic Kidney Disease--A Retrospective Cohort Analysis

Overview

Journal J Clin Hypertens (Greenwich)

Specialty Cardiology & Vascular Diseases

Date 2016 Jun 2

PMID 27246772

Citations 5

Authors

Heiko M Mundt

Matthias Matenaer

Alexander Lammert

Uwe Gottmann

Bernhard K Kramer

Rainer Birck

Urs Benck

Affiliations

Soon will be listed here.

Abstract

Resistant hypertension is still a challenge and reserve antihypertensive agents are often necessary to achieve blood pressure control. One reserve antihypertensive is minoxidil, a direct vasodilator that is known for its strong blood pressure-lowering effect, but contemporary studies are sparse. The authors retrospectively analyzed 54 inpatients with uncontrolled hypertension despite the combined use of current antihypertensive agents. To investigate the effect of minoxidil when added to other antihypertensive agents, blood pressure was evaluated at the time minoxidil treatment was initiated and at discharge. Minoxidil treatment was associated with a significant reduction in blood pressure from 162.4±15.1/83.2±12.7 mm Hg to 135.8±12.2/72.8±6.9 mm Hg (P<.0001). This effect was sustained across all analyzed subgroups. Although the well-known adverse events of minoxidil limit its widespread use, these data show that minoxidil as a reserve antihypertensive agent still has a niche indication in the particular subgroup of patients with treatment-resistant or uncontrolled hypertension.

Citing Articles

I Brazilian guideline on hypertension in dialysis of the Brazilian Society of Nephrology.

Rodrigues C, Ferreira-Filho S, Moura A, Poli-de-Figueiredo C, Silva D, Polacchini F J Bras Nefrol. 2025; 47(1):e20240033.

PMID: 40009791 PMC: 11864789. DOI: 10.1590/2175-8239-JBN-2024-0033en.

Topical minoxidil reported hair discoloration: a cross-sectional study.

Alhayaza G, Hakami A, AlMarzouk L, Al Qurashi A, Alghamdi G, Alharithy R Dermatol Reports. 2024; 16(1):9745.

PMID: 38623369 PMC: 11017712. DOI: 10.4081/dr.2023.9745.

Towards the Development of AgoKirs: New Pharmacological Activators to Study K2.x Channel and Target Cardiac Disease.

van der Schoor L, van Hattum E, de Wilde S, Harlianto N, van Weert A, Bloothooft M Int J Mol Sci. 2020; 21(16).

PMID: 32796537 PMC: 7461056. DOI: 10.3390/ijms21165746.

[Austrian Consensus on High Blood Pressure 2019].

Weber T, Arbeiter K, Ardelt F, Auer J, Aufricht C, Brandt M Wien Klin Wochenschr. 2019; 131(Suppl 6):489-590.

PMID: 31792659 DOI: 10.1007/s00508-019-01565-0.

Treatment of Hypertension in Chronic Kidney Disease.

Kalaitzidis R, Elisaf M Curr Hypertens Rep. 2018; 20(8):64.

PMID: 29892833 DOI: 10.1007/s11906-018-0864-0.

References

HAGSTAM K, Lundgren R, Wieslander J . Clinical experience of long-term treatment with minoxidil in severe arterial hypertension. Scand J Urol Nephrol. 1982; 16(1):57-63. DOI: 10.3109/00365598209179641. View

MacLeod D, Wathen C, Tucker L, Forret E, Hill T, Muir A . Felodipine can replace minoxidil in the treatment of refractory hypertension. J Hypertens Suppl. 1985; 3(3):S469-70. View

Mancia G, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G . 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013; 34(28):2159-219. DOI: 10.1093/eurheartj/eht151. View

Sica D . Minoxidil: an underused vasodilator for resistant or severe hypertension. J Clin Hypertens (Greenwich). 2004; 6(5):283-7. PMC: 8109604. DOI: 10.1111/j.1524-6175.2004.03585.x. View

Cuspidi C, Macca G, Sampieri L, Michev I, Salerno M, Fusi V . High prevalence of cardiac and extracardiac target organ damage in refractory hypertension. J Hypertens. 2001; 19(11):2063-70. DOI: 10.1097/00004872-200111000-00018. View

Papadopoulos D, Papademetriou V . Resistant hypertension: diagnosis and management. J Cardiovasc Pharmacol Ther. 2006; 11(2):113-8. DOI: 10.1177/1074248406289735. View

Dargie H, Dollery C, Daniel J . Minoxidil in resistant hypertension. Lancet. 1977; 2(8037):515-8. DOI: 10.1016/s0140-6736(77)90660-2. View

Cohn J, McInnes G, Shepherd A . Direct-acting vasodilators. J Clin Hypertens (Greenwich). 2011; 13(9):690-2. PMC: 8108999. DOI: 10.1111/j.1751-7176.2011.00507.x. View

Mann S . Drug therapy for resistant hypertension: simplifying the approach. J Clin Hypertens (Greenwich). 2011; 13(2):120-30. PMC: 8673425. DOI: 10.1111/j.1751-7176.2010.00387.x. View

10.

Kumar N, Calhoun D, Dudenbostel T . Management of patients with resistant hypertension: current treatment options. Integr Blood Press Control. 2013; 6:139-51. PMC: 3826290. DOI: 10.2147/IBPC.S33984. View

11.

Kern T, DeQuattro V, Bornheimer J, DeQuattro E, Kolloch R . Long-term effects of minoxidil therapy on renal function of patients with refractory hypertension: the significance of albuminuria. J Cardiovasc Pharmacol. 1980; 2 Suppl 2:S156-62. DOI: 10.1097/00005344-198000022-00009. View

12.

Persell S . Prevalence of resistant hypertension in the United States, 2003-2008. Hypertension. 2011; 57(6):1076-80. DOI: 10.1161/HYPERTENSIONAHA.111.170308. View

13.

Bomback A . Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease: Efficacy and Safety. Blood Purif. 2016; 41(1-3):166-70. DOI: 10.1159/000441262. View

14.

Nawar T, Nolin L, Plante G, Caron C, Montambault P . Long-term treatment of severe hypertension with minoxidil. Can Med Assoc J. 1977; 117(10):1178-82. PMC: 1880293. View

15.

Alpert M, Bauer J . Rapid control of severe hypertension with minoxidil. Arch Intern Med. 1982; 142(12):2099-104. View

16.

Chrysant S, Chrysant C, Sadeghi M, BERLIN L . Cardiac changes from beta-blocker, diuretic and minoxidil combination in hypertension. Cardiology. 1991; 78(1):45-52. DOI: 10.1159/000174764. View

17.

Traub Y, Redmond D, Rosenfeld J, MCDONALD Jr R, Shapiro A . Treatment of severe hypertension with minoxidil. Isr J Med Sci. 1975; 11(10):991-8. View

18.

Gilmore E, Weil J, CHIDSEY C . Treatment of essential hypertension with a new vasodilator in combination with beta-adrenergic blockade. N Engl J Med. 1970; 282(10):521-7. DOI: 10.1056/NEJM197003052821001. View

19.

Seedat Y, Rawat R . Minoxidil in combination with a beta-adrenergic blocker and a diuretic as an antihypertensive in patients refractory to available medications. S Afr Med J. 1981; 59(20):707-9. View

20.

Heagerty A, Bing R, Thurston H, Swales J . Nifedipine substituted for minoxidil in the treatment of refractory hypertension. J Hum Hypertens. 1987; 1(2):83-6. View