The management of severe hypertension with minoxidil in a once-a-day treatment regimen.

We evaluated the antihypertensive efficacy of "once-a-day" minoxidil, given in conjunction with a diuretic and sympatholytic, and the effect of this simple regimen on patient compliance. Twenty-one severely hypertensive patients had their existing antihypertensive regimens changed to a single daily dose of chlorthalidone (50-100 mg) and either nadolol (160 mg) or reserpine (.25 mg) for a 3-week period. After stabilization on these two drugs, a single daily dose of minoxidil (2.5 mg) was added to each patient's regimen. Doses were titrated as necessary to achieve diastolic blood pressures of less than 90 mmHg. After 3 and 6 months of maintenance therapy, blood pressures were measured 24 hours after the previous day's dosing to evaluate the persistence of the antihypertensive effect. Twenty-four-hour blood pressure control was achieved on 76% of these occasions, and on at least one occasion in 90% of the patients. In addition, compliance was excellent.