Does low dose oral minoxidil affect blood pressure?

Does low dose oral minoxidil affect blood pressure?

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Well, there has been a handful of research studies that have examined whether low dose oral minoxidil affects blood pressure.

Sanabria et al in 2022 showed that 5 mg of oral minoxidil use in 34 males lowered systolic blood pressure by 3 mm Hg and diastolic blood pressure by 2 mm Hg when followed over a long period of time.

Jimenez-Cauhe J et al. showed that 5 mg of oral minoxidil had minimal changes in blood pressure when 10 males were followed closely for 24 hours. However, the only time point where it did have an effect was a 2 hours after intake where diastolic blood pressure dropped from 77 mm Hg to 72 mmHg before recovering completely.

Two new studies this year support the general view that low dose oral minoxidil has minimal effects on blood pressure.

A study by Ong et al in 151 males and females at a mean dose of around 2 mg showed that blood pressure did not really change much at all in users. The one exception was males 35-49 years of age where diastolic blood pressure dropped 3 mm Hg. This was not felt to be clinically significant.

A study by Imhof et al in 25 female patients using a variety of doses showed that systolic blood pressure dropped 2.8 mm Hg and diastolic blood pressure dropped 1.4 mm Hg but for the most part this seemed not all that clinically significant.

Conclusion:

All in all, low dose oral minoxidil can lower blood pressure but if it does … it’s a very minimal amount and for the most part clinically insignificant.
Our blood pressure, as humans, swings 20-60 mm Hg throughout our typical day. Blood pressure drops about 10 mm Hg when we sleep and rises 10-50 mmHg when we exercise. These tiny changes in blood pressure with low dose oral minoxidil are probably not an issue for most patients. Nevertheless, occasional patients may be sensitive to these tiny changes.

Reference

Sanabria et al. J Am Acad Dermatol. 2022
Jimenez-Cauhe J et al. J Am Acad Dermatol. 2022
Ong M et al. J Am Acad Dermatol. 2023
Imhof R et al. JAAD Int. 2023