Minoxidil

Minoxidil is the most potent of the drugs that lower blood pressure by dilating the peripheral arteries. This drug, however, does not work through the peripheral sympathetic nervous system, as do the alpha and beta-blocker drugs, or through the control center in the brain, as does clonidine. Rather, it is a muscle relaxant that works directly on the smooth muscle of the peripheral arteries throughout the body. Minoxidil is used for patients who have not responded to any other medications. It must be combined with a beta-blocker or clonidine to prevent an increase in the heart rate and with a diuretic to prevent retention of fluid (swelling). Minoxidil may also increase hair growth. So Minoxidil is also used for baldness.

What about the patient's compliance with medication regimes?

When uncomplicated hypertension has not caused symptoms, as often happens, some patients tend to forget about their medications. Patients also tend to fail to take their medications as prescribed (non-compliance or non-adherence) if they are causing side effects. Remember that quality of life issues are very important, especially with regard to compliance with prescribed blood pressure medications. Thus, certain anti-hypertensive medications may cause such side effects as fatigue and sexual impotence. These side effects understandably can have profound effects on the patient's quality of life and compliance with treatment. Likewise, more resistant cases of hypertension that require more medication may cause more adverse effects, and, therefore, less compliance.

In dosing schedules that require taking medication 2 to 4 times a day (split dose), some patients will remember to take their medicine only some of the times. In contrast, medications that can be given once daily tend to be remembered more regularly.

Expensive blood pressure medications, especially if insurance does not cover the costs, may also reduce compliance. The reason for this is that people attempt to save money by skipping doses of the prescribed medication. Remember that the least expensive medication regimes use generic (not brand name) drugs, such as are readily available for some of the diuretics and beta-blockers. Reduced costs of medication may also be achieved by lifestyle changes such as losing weight, reducing dietary sodium, decreasing consumption of alcohol, and exercising regularly. If these changes in lifestyle are effective, the patient may require less medication. For further information, please read the natural treatment of hypertension.