Hypertension is extremely common in renal allograft recipients, mainly as the result of impaired renal function and cyclosporin A therapy. Blood pressure is a powerful independent predictor of longterm graft outcome. This adverse effect is presumably mediated by both hemodynamic and non-hemodynamic factors. There is also evidence for activation of the renin angiotensin system in the renal allograft. Antihypertensive treatment is of known benefit on graft outcome in experimental models, but this has so far not been documented in clinical trials. Proteinuria is another independent predictor of longterm graft outcome. There is recent documentation of a specific antiproteinuric effect of ACE inhibitors on proteinuria which is of interest since proteinuria is an independent predictor of longterm graft outcome.