Patients with systemic sclerosis who develop hypertension should be treated with an ACE inhibitor. Improved survival and successful discontinuation of dialysis are possible when ACE inhibitors are used to treat scleroderma renal crisis.

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SUMMARY Tests made of the sensory-perceptual, cognitive, and psychomotor abilities of untreated young patients with essential hypertension have revealed a pattern suggesting a slight functional impairment of the central nervous system. Reduced performance was most marked for those tasks requiring speed arid psychomotor coordination, particularly when the behaviors observed were self-initiated. Lowered scores were more evident among female hypertensives; no differences in performance by race were noted. The deficits measured by these sensitive tests do not appear to be great enough to intrude on everyday activity nor to impair work ability. Changes that may result from blood-pressure-lowering therapies will require further study. (Hypertension 4: 355-360, 1982) KEY WORDS • mild hypertension • behavioral consequences • psychological tests

Potentially interactive effects of hypertension and age on the performance of neuropsychological and information processing tests were examined in 123 untreated hypertensive and 50 normotensive men. After covarying education, average alcohol consumption, trait anxiety, and depression scores, results indicated an interaction of age and hypertension. Young hypertensive men (23-40 years) scored significantly worse than young normotensive men on tests of attention/executive function and working memory; middle-aged hypertensive (41-56 years) and normotensive participants were not distinguished by any measures. Hypertensive men performed significantly more poorly than normotensive men on tests of manual dexterity. Results suggest that neuropsychological sequelae of hypertension are more pronounced in young than in middle-aged hypertensive individuals and are independent of various demographic, psychosocial, and alcohol-related factors.