[ACE inhibitors in the diagnosis and therapy of various forms of hypertension].

The diagnostic and therapeutic aspects of ACE inhibitors in patients with various forms of hypertension are discussed. The immediate blood pressure reduction after administration of an ACE inhibitor is significantly more marked in patients with renovascular than with essential hypertension. However, analysis of the individual blood pressure response after captopril does not allow a clear distinction between these two forms of hypertension. In patients with moderate hypertension the reduction of blood pressure with ACE inhibitors is similar to that with betablockers. Their use as a first step agent in moderate hypertension, however, is limited to selected patients. In severe drug-resistant hypertension treatment with ACE inhibitors is well established. Cases with renovascular hypertension may suffer a deterioration of renal function under ACE inhibitors. Other side effects are uncommon where renal function is normal or where the dose is adapted to the decreased glomerular filtration rate.