ACE inhibitors and diuretics

Hypertension and its consequences continue to threaten the health of as many as 60 million Americans. Effective control of blood pressure can be achieved in some patients with a single agent and in many of the remainder with combination therapy. The ideal combination regimen is one that is at least as effective as a single agent, has minimal or no side effects, has a wide therapeutic index, is simple to administer, and is effective in a wide variety of patient populations. When used in combination, the thiazide diuretics and the angiotensin-converting enzyme inhibitors have been shown to improve blood pressure reduction over either drug used alone. In addition, the combination is effective in a wide range of patient populations (blacks and whites, young and old) and is accompanied by fewer adverse metabolic effects than the thiazides alone. Finally, the combination has a more positive impact on quality of life than other combinations involving the thiazide diuretics.