Angiotensin converting enzyme (ACE) inhibitors in hypertensive aircrew

Essential, uncomplicated hypertension is not uncommon in young or middle-aged aircrew. The choice of treatments available for its treatment was largely limited to diuretics and some accepted beta-adrenergic blockers. It is only 4 years since the choice was extended to the calcium-channel-blockers and the angiotensin converting enzyme (ACE) inhibitors, in civil aviation. In military aviation in the U.K., ACE inhibitors have been in use for less than 2 years. This paper surveys these choices and makes the case for the use of ACE-inhibitors, under controlled conditions. It also emphasizes that the functional studies, conducted to show the safety of ACE-inhibitors, were more comprehensive than for any of the predecessors. These methods of study should serve as models for the study of any drug in the future, before it is authorized for use in the aircrew.