Thirty Nigerian hypertensives with heart failure and 30 without heart failure, matched for age and sex, were studied. Diastolic blood pressures were similar in the two groups (118 +/- 15 and 118.5 +/- 13.6 mmHg, respectively) (P greater than 0.5), while systolic blood pressures were higher in the non-heart failure group (176.7 +/- 29.7 and 198.8 +/- 29.8 mmHg, respectively) (P less than 0.01). The mean durations of initial detection of high blood pressure in the previously known hypertensives in the two groups were 4.9 +/- 3.8 and 4.4 +/- 3.3 years, respectively (P greater than 0.05), and their drug compliance prior to this study was similarly poor (P greater than 0.1). In the two groups, 33.3% and 10% were thiamine deficient, respectively (P less than 0.001), with TPP greater than 15%; 23.3% and 0% had hypoalbuminaemia (P less than 0.02), with a mean serum albumin of 35 +/- 7 and 42 +/- 3 g/l, respectively (P less than 0.001); while 36.7% and 13.3% were anaemic, respectively (P less than 0.05). Heart failure was more severe in those with more than one of these adverse factors (P less than 0.05). The results suggest that these factors, more prevalent in the heart failure group, would have hastened and worsened their heart failure. It is suggested that an active nutritional approach be incorporated into the management of hypertensives, particularly in the developing world.