Oral Minoxidil in the Treatment of Hypertensive Crisis

Abstract

WITH the advent of aggressive antihypertensive therapy, the mortality of patients with malignant hypertension has been drastically reduced. Because of new forms of drug therapy, bilateral nephrectomy, once recommended for severe and controlled hypertension, is no longer indicated.1In fact, studies often indicate improvement in renal function once control of blood pressure (BP) is obtained.2 Parenteral drugs such as diazoxide and sodium nitroprusside have replaced slower, less predictably acting antihypertensives for the rapid lowering of BP. However, if the patient fails to respond to these drugs, he still faces nephrectomy as a therapeutic choice. We report the case of a patient who failed to respond to high doses of sodium nitroprusside but had a rapid lowering of BP following oral administration of minoxidil, an experimental vasodilator used principally for the control of chronic refractory hypertension.3 Report of a Case A 15-year-old girl was referred to a neurosurgeon