Angiotensin converting enzyme inhibitors enhance the antihypertensive efficacy of diuretics and blunt or prevent adverse metabolic effects.

Angiotensin converting enzyme (ACE) inhibition has provided a new approach to the treatment of hypertension. The broad efficacy of ACE inhibitors across the entire spectrum of hypertension exceeds original predictions. Diuretics have been shown to extend efficacy to over 85% of noncomplicated hypertensives. In addition to efficacy, combination of ACE inhibitors with diuretics permits prevention or attenuation of many undesirable side effects of diuretic therapy, including hypokalemia, hyperuricemia, hyperglycemia, and hypercholesterolemia. Thus, considerations of both efficacy and beneficial effects on cardiovascular disease risk factors make the combination of ACE inhibitors and diuretics an attractive one in the treatment of hypertension.