Angiotensin converting enzyme inhibitors in the clinic: quality of life.

In mild to moderate hypertension the benefit:risk ratio of treatment cannot be predicted for an individual patient. Antihypertensive drug therapy can therefore only be justified if the patient's quality of life remains unimpaired. Angiotensin converting enzyme (ACE) inhibitors are considered to improve the 'quality of life'. However, only two trials have assessed the influence of antihypertensive drugs on 'quality of life', and it is interesting that both used captopril as a comparative drug. Although both studies differed in their 'quality-of-life' definitions and in their assessment methods, in the overall analysis of change, both favoured captopril. There are no published trials comparing the effects of enalapril with other antihypertensive agents on major aspects of quality of life. Our own results show that enalapril and atenolol are equivalent, both in terms of antihypertensive efficacy and incidence of side effects.