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To describe the characteristics and renal function of hypertensive patients at their first hospital admission in Sub-Saharan Africa.Retrospective study of all hypertensive patients.Department of Cardiology and Internal Medicine of Yalgado Ouedraogo National Hospital in Burkina Faso, a country in Sub-Saharan Africa.Three hundred and seventeen consecutive hypertensive patients (systolic blood pressure ≥160mmHg or diastolic blood pressure ≥90mmHg, or both, or patients receiving antihypertensive treatment) referred between 1 November 1988 and 31 October 1990.The hypertensive patients accounted for 36.5% of admissions and included 198 males and 119 females (mean ± SD age 49 ± 14 years). Two-thirds of the patients belonged to the poorer socio-economic groups. Hospital admission was necessary because of the symptoms and complications of hypertension: 43% had diastolic blood pressure >130mmHg, 73.5% had at least one target organ affected and 38.2% had renal involvement in the form of chronic renal failure or as proteinuria >1.5g/24h. Patients with renal involvement were younger and had blood pressure that responded less well to acute treatment. One-fifth of the patients died during their hospital stay, and most of these had impaired renal function.