[Converting enzyme inhibitors in the diagnosis of secondary arterial hypertension --focus on the captopril test].

The first application of angiotensin converting enzyme (ACE) inhibitors it was the treatment of arterial hypertension. Latter news application appears such as: heart failure, myocardial infarct, nephropathy and diabetic proteinuria. Captopril, the first oral ACE inhibitor was used, since 1986, in the diagnostic screening of renovascular hypertension (RVH). Since then other authors recognised the importance of captopril test in the detection of RVH, advising also it's application in the diagnosis of primary aldosteronism and pheocromocithoma. Based in different publications the sensitivity of captopril test is 40%-100% and the specificity 72%-100%. There are several reasons to explain the differences between these results. In our opinion, these observations appeared as a consequence of the different methodology used. Despite the fact that alternative procedures to captopril test in the screening of RVII do exist this is, in our opinion, the most simple, cheap, safe and efficient test available at the moment.