[Some approaches to the treatment of hypertension, refractory to hypotensive agents]

The furosemid test followed by PRA evaluation in 83 hypertensive patients has revealed 22% of patients highly sensitive to diuretics. Their treatment with diuretics alone during 6-12 months had a good antihypertensive effect. In 42% of patients antihypertensive effect was achieved by continuous long-term treatment with diuretics supplemented periodically with short-term courses of beta-blockers or Korinfar. In 9 patients with stage II B hypertension refractory to hydrochlorothiazide, PGE2 infusion was performed, which increased the patients' drug sensitivity and reduced blood pressure. Of 134 patients with hypertension refractory to antihypertensive agents and associated with some clinical and biochemical signs of primary hyperaldosteronism 38 had adrenal adenoma and 34 adrenal idiopathic hyperplasia. All the patients were adequately treated.