Minoxidil in daily doses of 6 to 40 mg was administered to 11 patients with severe hypertension. Two patients died of causes unrelated to the drug and one patient withdrew from the study. Blood pressure was controlled in the remaining eight subjects, who received the drug for periods ranging from 5 to 40 months. In three patients minoxidil could subsequently be replaced by conventional antihypertensive therapy. Adverse effects of minoxidil included fluid retention (as assessed by edema and plasma volume studies), nonspecific ECG changes, hypertrichosis and conjunctival redness. Concomitant administration of diuretic and beta-adrenergic blocking agents resulted in excellent tolerance of the treatment and high patient compliance.