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Ramipril is an effective and well-tolerated antihypertensive in various patient groups including the elderly and those with some concomitant conditions, such as diabetes mellitus. Moreover, the efficacy of ramipril does not differ significantly from that observed with other ACE inhibitors or drugs from other classes (e.g. diuretics).Extensive experience in large, noncomparative general practice trials indicates that ≤5% of patients discontinue ramipril because of adverse effects. Qualitatively, the tolerability profile of ramipril resembles that of other ACE inhibitors.Thus, ramipril appears worthy of consideration for inclusion on formulary lists, particularly where it is competitively priced.