Newer antihypertensive agents. When to try them

Captopril (Capoten) and minoxidil (Loniten) have recently become generally available for treatment of hypertension and calcium channel blockers, although not yet officially approved for this indication, clearly have potential as antihypertensive agents. Captopril, the only available inhibitor of angiotensin-converting enzyme, is particularly effective in patients with severe, high-renin hypertension. Minoxidil, a potent direct-acting vasodilator, is particularly effective in severely hypertensive patients with concomitant renal insufficiency. Because serious side effects have been noted with both drugs, their use probably should not be considered until other agents have failed. Of the calcium channel blockers, nifedipine (Procardia) seems to have greatest promise as an antihypertensive agent.