[Hypertension refractory to treatment. Case-control study]

From a clinical population of 1290 subjects consecutively hospitalized between oct. 1969 and dec. 1976, 343 were re-examined at least three times during the four subsequent years, and their blood pressure at the 2nd and 3rd re-examinations were averaged (BPfu). Two types of refractory hypertensive were arbitrarily defined; type A: 58 subjects whose BPfu was greater than or equal to 200 and/or 120 mmHg, and type b: 53 subjects whose BPfu was greater than or equal to 107,5% of the average BP during the first four days of the initial hospitalisation. Two case-control studies showed that type A cases had initially significantly more severe hypertension (higher systolic and diastolic BP, and for the same BP, more severe cardiac and retinal involvement) than the controls; the mortality in 8,7 years reached 36%, for the cases and only 18% for the matched controls (p less than 0,05). Two similar case-control studies showed that type B cases had initially significantly lower systolic and diastolic BP, were significantly less treated and more prone to side-effects; the mortality in 8,9 years reached 25,6% for the cases, and 20,5% for the matched controls (n.s.).