ACE inhibitors and strategies for managing hypertension

Angiotensin converting enzyme inhibitors are effective hypotensive agents, lowering blood pressure in patients with mild to moderate hypertension either alone or in combination with a low dose loop diuretic. They are generally well tolerated and score well in quality of life studies. However, in some patients they do cause cough, which may lead to their withdrawal, and their association with renal failure and death in elderly patients may reduce their usefulness in this age group. Nevertheless they have established a role as first line therapy in patients with asthma and diabetes.