Which drug may aggravate renovascular hypertension?

ANSWER: (A) ACE inhibitorsREF: Harrison 17th ed chapter 241Deterioration of renal function or deterioration of renal function associated with an ACE inhibitor should raise the possibility of renovascular hyper tens ion.These agents decrease glomerular filtration rate in the stenotic kidney owing to efferent renal arteriolar dilation. In the presence of bilateral renal artery stenosis or renal artery stenosis to a solitary kidney, progressive renal insufficiency may result from the use of these agents. Importantly, the renal insufficiency is generally reversible following discontinuation of the offending drug.