In a double-blind study, we compared the value of different approaches to assess blockade of angiotensin (Ang) II generation in 10 normal volunteers treated with the new Ang-converting enzyme (ACE) inhibitor temocapril. Plasma concentration of the diacid active metabolite of temocapril, plasma Ang I and II levels, plasma ACE activity, and inhibition of the pressor response to repeated intravenous (i.v.) doses of Ang I were measured before and repeatedly after different doses of tempocapril or placebo. In vivo ACE activity, estimated by the plasma Ang II/Ang I ratio, correlated well with temocapril diacid concentration (r = 0.85, n = 148) and with systolic and diastolic blood pressure (SBP, DBP) responses to Ang I (r = 0.76 and r = 0.79, n = 148). SBP and DBP responses to Ang I were also strongly related to temocapril diacid concentration (r = -0.81 and r = -0.88, n = 148). ACE activity measured in vivo reliably predicts the decrease in Ang-dependent BP to be achieved by ACE inhibitors.