Decrease in blood pressure after administration of ACE inhibitors, námely following the first dose in patients at risk, can cause anxiety in some physicians anticipating their administration or the continuing in further treatment. Therefore, the authors present a review of the problems on the basis of a review of clinical studies as well as of their own experience. Analyzed are situations under risk and recommendation for the selection of appropriate ACE inhibitors in which the risk of hypotension following the first dose is lower (fosinopril, perindopril). Taking into account the risk as well as the choice of a suitable ACE inhibitor in patients at risk, the launching of therapy with ACE inhibitors in patients ander risk as safe.

        Key words: ACE inhibitors - heart failure - myocardial infarction - hypotension following first dose