Page 6
Use of ACE inhibitors in the treatment of essential hypertension:
An ACE inhibitor is the most appropriate initial drug for younger (<55 years) patients who are not of black African or
black Caribbean descent.
ACE inhibitors are particularly valuable for hypertension in insulin-dependent diabetics with nephropathy - the beneficial effect in preventing overt renal failure may involve not only the lowering of blood pressure but also reduced production of cytokines that promote tubulo-interstitial fibrosis.
They may reduce blood pressure very rapidly in some patients (especially those being treated with diuretics). The initial dose of the ACE inhibitor should preferably be given at bedtime.
They are contra-indicated in pregnancy.
Caution should be exercised in breast feeding.
Caution should be exercised when prescribing ACE inhibitors for patients with stenosis of a renal artery...
