Central and peripheral mechanisms of formation of primary and symptomatic arterial hypertension are considered. The existence of a hypertonic disease as precise nosological entry is grounded. Significance of RAAS in the pathogenesis of arterial hypertension is discussed in detail, as well as the place of ACE inhibitors in therapy of these and accompanying disorders. On the basis of the clinical study PROGRESS a conclusion is made regarding high efficacy of new ACE inhibitor perindopril (Prestarium) and its combination with a diuretic indapamide as mean of prevention of stroke and other major outcomes of vascular disease. Good tolerance of perindopril is emphasized, especially with elderly patients, and also high level of adherence of patients to the tretment with this preparation.