Increased prevalence of cardiovascular complications in women with furosemide resistant essential hypertension

Patients with essential hypertension (n = 2969) who had not been taking any blood pressure medication for longer than 1 week were classified as furosemide-sensitive (FS) if their diastolic BP after furosemide fell greater-than-or-equal-to 10% and furosemide-resistant (FR) if it fell less than that. The FS group was significantly (P less-than-or-equal-to .05) older, and had higher blood pressure than the FR group. In patients over age 50, the prevalence of cardiovascular complications (myocardial infarction, stroke, angina, congestive heart failure, and intermittent claudication) in the FR group (12.3%) was significantly (P = .0039) more than in the FS group for all patients, and especially for women (P = .0053). This was not explained by plasma renin activity, plasma norepinephrine, obesity index, cholesterol, blood sugar, or smoking history, and was associated in the FR group with a lower BP. This study characterizes the furosemide response of BP in hypertensive subjects and demonstrates an increased prevalence of cardiovascular complications in women over age 50 in the furosemide resistant group.