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Minoxidil and captopril in severe hypertension

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Summary

The antihypertensive efficacy of minoxidil and captopril was compared in 23 males with essential or renal parenchymatous hypertension refractory to conventional antihypertensive drug therapy. Following a pretreatment period the patients were randomly assigned to receive either minoxidil, 2.5 mg twice daily (n=12), or captopril, 25 mg twice daily (n=11). In patients with diastolic blood pressure >95 mmHg, doses of minoxidil and captopril were increased in 2-week intervals. Patients who maintained diastolic pressure >95 mmHg and/or those with intolerable side effects were switched over to the alternative substance. After a mean observation period of 12 weeks a significant decrease in systolic and diastolic blood pressure was observed (179/114 vs 148/92 mmHg in the minoxidil group; 176/111 vs 158/97 mmHg in the captopril group). The primary response rate was 75% in patients treated with minoxidil and 55% in those with captopril (not significant). After the change to the alternative substance two of the four non-responders on captopril and one of the two non-responders on minoxidil became responders. Side effects occurred significantly more often during minoxidil than captopril (p<0.05). The high efficacy of minoxidil and captopril in the treatment of severe hypertension refractory to conventional drugs was confirmed. Minoxidil lowered blood pressure slightly more than captopril, but it had a higher incidence of side effects than captopril.

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References

  1. Atkinson AB, Lever AF, Brown JJ, Robertson JIS (1980) Combined treatment of severe intractable hypertension with captopril and diuretic. Lancet II:105–108

    Google Scholar 

  2. Bauer JH, Alpert MA (1980) Rapid reduction of severe hypertension with minoxidil. J Cardiovasc Pharmacol [Suppl] 2:189–199

    Google Scholar 

  3. Bennett WM (1977) Pericardial effusions associated with minoxidil. Lancet II:1356

    Google Scholar 

  4. Bravo E, Tarazi RC (1979) Converting enzyme inhibitor with an orally active compound in hypertensive man. Hypertension 1:39–46

    Google Scholar 

  5. Brunner HR, Gavras H, Waeber B, Kershaw GR, Turini GA, Vukovich RA, Mc Kinstry DN, Gavras I (1979) Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med 90:19–23

    Google Scholar 

  6. Brunner HR, Gavras H, Waeber B, Textor SC, Turini GA, Wanters JP (1980) Clinical use of an orally acting converting enzyme inhibitor: captopril. Hypertension 2:558–566

    Google Scholar 

  7. Brunner HR, Jaeger P, Ferguson RK, Jequier E, Turini G, Gavras H (1978) Need for beta-blockade reduced with long-term minoxidil. Br Med J II:385–388

    Google Scholar 

  8. Bryan RK, Hoobler SW, Rosenzweig J, Weller JM, Purdy JM (1977) Effect of minoxidil on blood pressure and hemodynamics in severe hypertension. Am J Cardiol 39:796–801

    Google Scholar 

  9. Campese VM (1981) Minoxidil: a review of its pharmacological properties and therapeutic use. Drugs 22:257–278

    Google Scholar 

  10. Canaday B (1980) Minoxidil. South Med J 73:59–64

    Google Scholar 

  11. Case DB, Atlas SA, Sullivan PA, Laragh JH (1981) Acute and chronic treatment of severe and malignant hypertension with the oral angiotensin-converting enzyme inhibitor captopril. Circulation 64:765–771

    Google Scholar 

  12. Devine BL, Fife R, Trust PM (1977) Minoxidil for severe hypertension after failure of other hypotensive drugs. Br Med J II:667–669

    Google Scholar 

  13. Edwards CRW, Padfield PL (1985) Angiotensin-converting enzyme inhibitors: past, present, and bright future. Lancet I:30–34

    Google Scholar 

  14. Mac Gregor GA, Markandu ND, Roulsten JE, Jones JC (1979) Essential hypertension: effect of an oral inhibitor of angiotensin-converting enzyme. Br Med J II:1106–1109

    Google Scholar 

  15. Haber E, Koerner T, Page LB, Kliman B, Purnode A (1969) Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. J Clin Endocrinol Metab 29:1349–1355

    Google Scholar 

  16. Havelka J, Vetter H, Studer A, Greminger P, Lüscher T, Wollnik S, Siegenthaler W, Vetter W (1982) Acute and chronic effects of the angiotensin-converting enzyme inhibitor captopril in severe hypertension. Am J Cardiol 49:1467–1474

    Google Scholar 

  17. Heel RC, Brogden RN, Speight TM, Avery GS (1980) Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs 20:409–452

    Google Scholar 

  18. Kaplan NM (1984) Systemic hypertension: therapy. In: Braunwald E (ed) Heart disease. Saunders, Philadelphia, pp 902–927

    Google Scholar 

  19. Keusch GW, Weidmann P, Campese V, Lee DBN, Upham AT, Massry SG (1978) Minoxidil therapy in refractory hypertension. Analysis of 155 patients. Nephron 21:1–15

    Google Scholar 

  20. O'Malley K, Velasco M, Wells J, Mc Nay JL (1975) Control plasma renin activity and changes in sympathetic tone as determinants of minoxidil-induced increase in plasma renin activity. J Clin Invest 55:230–235

    Google Scholar 

  21. Meier A, Weidmann P, Ziegler WH (1981) Catecholamines, renin, aldosterone, and blood volume during chronic minoxidil therapy. Klin Wochenschr 59:1231–1236

    Google Scholar 

  22. Metha PK, Mamdani B, Shansky RM, Mahurkar SD, Dunea G (1975) Severe hypertension. Treatment with minoxidil. J Am Med Assoc 233:249–252

    Google Scholar 

  23. Pettinger WA, Mitchell HC (1973) Minoxidil — an alternative to nephrectomy for refractory hypertension. New Engl J Med 289:167–173

    Google Scholar 

  24. Raine AEG, Ledingham JGG (1982) Clinical experience with captopril in the treatment of severe drug-resistant hypertension. Am J Cardiol 49:1475–1479

    Google Scholar 

  25. Smith SJ, Markandu ND, Mac Gregor GA (1982) Optimal dose of captopril in hypertension. Lancet II:1460

    Google Scholar 

  26. Veterans Administration Cooperative Study Group on Antihypertensive Agents (1982) Captopril: evaluation of low doses, twice daily doses and the addition of a diuretic for the treatment of mild to moderate hypertension. Clin Sci [Suppl] 63:443s-445s

    Google Scholar 

  27. Veterans Administration Cooperative Study Group on Antihypertensive Agents (1982) Racial differences in response to low-dose captopril are abolished by the addition of hydrochlorothiazide. Br J Clin Pharmacol [Suppl] vol.:97s-101s

    Google Scholar 

  28. Vetter W, Vetter H, Siegenthaler W (1973) Radioimmunoassay for aldosterone without chromatography. II. Determination of plasma aldosterone. Acta Endocrinol 74:558–657

    Google Scholar 

  29. White NJ, Rajagopalan B, Yahaya H, Ledingham JGG (1980) Captopril and furosemide in severe drug-resistant hypertension. Lancet II:108–110

    Google Scholar 

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Authors and Affiliations

  1. Departement für Innere Medizin, Universitätsspital Zürich, Schweiz

    P. Greminger, E. Foerster, H. Vetter, P. Baumgart & W. Vetter

  2. Medizinische Universitätspoliklinik, Münster

    P. Greminger, E. Foerster, H. Vetter, P. Baumgart & W. Vetter

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  1. P. Greminger
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  2. E. Foerster
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  3. H. Vetter
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  4. P. Baumgart
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  5. W. Vetter
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Greminger, P., Foerster, E., Vetter, H. et al. Minoxidil and captopril in severe hypertension. Klin Wochenschr 64, 327–332 (1986). https://doi.org/10.1007/BF01711952

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  • DOI: https://doi.org/10.1007/BF01711952

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