A member asked:

Why are ace inhibitors usually not the first line of drug therapy in newly diagnosed cases of hypertension among elderly (55+years)?

5 doctors weighed in across 2 answers

See below: In fact ace inhibitors and calcium blockers are recommended first line agents.

Answered 9/28/2016

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ACEI for High BP: There is no reason to avoid acei in 55+ hypertensives. There is a misperception that acei cause kidney dysfunction, but there's no evidence for that in clinical trials. Acei also were felt to be less effective in the elderly: not true in most cases. Finally, practice guidelines recommend diuretics as the preferred first-line rx in all adults, but that will likely change shortly with new guidelines.

Answered 9/22/2016

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