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May 1986

Minoxidil, Nadolol, and a Diuretic: Once-a-Day Therapy for Resistant Hypertension

Author Affiliations

From the Division of Nephrology and Hypertension, Department of Medicine, Brookdale Hospital Medical Center, Linden Boulevard at Brookdale Plaza, Brooklyn, NY.

Arch Intern Med. 1986;146(5):882-886. doi:10.1001/archinte.1986.00360170078013

• We tested a once-a-day antihypertensive regimen using minoxidil, nadolol, and a diuretic in 55 patients with resistant hypertension. Forty-seven patients had evidence of end-organ damage. Twelve had mild renal insufficency (serum creatinine concentration, 2.5±0.3 mg/dL). In 34 patients, treatment with nadolol and a diuretic was started with minoxidil added one to four weeks later. In the remainder, minoxidil, nadolol, and a diuretic were begun simultaneously because of severe hypertension. Initial supine and standing blood pressure (BP) in the 55 patients were 186±4/111± 2 and 180±4/108±2 mm Hg, respectively. After 7 ±1 weeks, BP was controlled in 46 patients (84%) with the supine and standing BP reduced to 140 ± 3/80 ± 1 and 134±3/80±1, respectively. In six patients, BP was controlled but intolerable side effects occurred, making the regimen therapeutically successful in 40 patients (73%). The BP remained controlled during a follow-up of 43 ±5 weeks. In 31 patients, BPs measured 24 hours after the last dose were not different from random measurements. Mean serum creatinine levels remained stable in the 12 patients with renal insufficiency.

(Arch Intern Med 1986;146:882-886)

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