This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
Which drug may aggravate renovascular hypeension 
Select and explain. 
A. ACE inhibitors, B. Beta blockers, C. Calcium channel blockers, D. Thiazide diuretics
A: ACE inhibitors
Answer: A: ACE inhibitors 
Explanation: ACE inhibitors REF: Harrison 17th ed chapter 241 Deterioration of renal function or deterioration of renal function associated with an ACE inhibitor should raise the possibility of renovascular hypeension. These agents decrease glomerular filtration rate in the stenotic kidney owing to efferent renal aeriolar dilation. In the presence of bilateral renal aery stenosis or renal aery stenosis to a solitary kidney, progressive renal insufficiency may result from the use of these agents. Impoantly, the renal insufficiency is generally reversible following discontinuation of the offending drug.