Cough during Treatment with Angiotensin Converting Enzyme Inhibitors

Strocchi, Enrico; Malini, Pier Luigi; Valtancoli, Gianpaolo; Ricci, C; Bassein, Leona; Ambrosioni, Ettore

doi:10.1007/bf03258383

Cited by 24 publications

(12 citation statements)

References 13 publications

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“…It was hypothesised that chronic exposure to tobacco smoke desensitises the cough receptors lying superficially within the airway epithelium. Supporting the present authors' speculation is the demonstrated lower incidence of angiotensinconverting enzyme inhibitor-induced cough in smokers relative to nonsmokers [4,5], and anecdotal observations that cough often transiently increases after smoking cessation [6].…”

supporting

confidence: 76%

Effect of smoking cessation on cough reflex sensitivity

et al. 2006

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Recent studies have shown that cigarette smokers have diminished cough reflex sensitivity compared with nonsmokers. The current authors proposed a mechanism of chronic cigarette smoke-induced desensitisation of airway cough receptors.To investigate this hypothesis, cough sensitivity to inhaled capsaicin (C 5 ) in chronic smokers was measured both while they were actively smoking and 2, 6, 12 and 24 weeks after smoking cessation.In total, 29 subjects underwent baseline capsaicin challenge while smoking and 2 weeks after smoking cessation. Mean¡SEM log C 5 fell from 1.86¡0.12 to 1.60¡0.12, demonstrating significant enhancement of cough reflex sensitivity. Of the total, 20, 18 and 14 subjects successfully abstained from smoking for 6, 12 and 24 weeks, respectively. Mean log C 5 values after 12 and 24 weeks of smoking cessation were significantly diminished from baseline. In a control group of smokers, mean log C 5 did not decrease from baseline after 6, 12 and 24 weeks. Overall, the log C 5 profile of the smoking cessation group showed a clear, linearly decreasing trend over time compared with the control group.Even after many years of smoking, cough sensitivity is enhanced as early as 2 weeks after smoking cessation. Given the importance of an intact cough reflex, these changes may provide clinical benefit.

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supporting

confidence: 76%

Effect of smoking cessation on cough reflex sensitivity

et al. 2006

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“…In our study, female sex was also significantly higher and smoking rates were significantly lower in the study group compared to controls. These results corroborate the results of previous studies on this subject and interestingly also studies dealing with the profiles of asthma . Also, GERD symptoms were significantly higher in patients with ACE‐I induced cough.…”

Section: Discussionsupporting

confidence: 91%

“…ACE‐I‐induced cough is predominantly seen in females and nonsmokers . In our study, female sex was also significantly higher and smoking rates were significantly lower in the study group compared to controls.…”

Section: Discussionsupporting

confidence: 53%

“…ACE-I-induced cough is predominantly seen in females and nonsmokers. 2,[27][28][29][30][31] In our study, female sex was also significantly higher and smoking rates were significantly lower in the study group compared to controls. These results corroborate the results of previous studies on this subject and interestingly also studies dealing with the profiles of asthma.…”

Section: T a B L E 2 Comparison Of Asthmasupporting

confidence: 54%

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The presence of underlying asthma should be investigated in patients diagnosed with ACE inhibitor induced cough

Yılmaz

Türk

Ketencioğlu

et al. 2020

Clinical Respiratory J

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Introduction Why do only some of patients who are prescribed angiotensin converting enzyme inhibitors (ACE‐I) develop cough? The pathogenesis of ACE‐I‐induced cough remains controversial and requires further studies. Objective We aim to investigate whether asthma is a contributing cause of ACE‐I‐induced cough. Methods Patients attending a cardiology clinic between March 2016 and March 2017 who were diagnosed with ACE‐I induced cough were included in this study. ACE‐I‐induced cough was defined as cough which developed within 4 weeks after initiation of ACE‐I therapy and which improved within 4 weeks after discontinuation of the ACE‐I. Patients who had received ACE‐I treatment for at least 6 months without side effects were included in the study as a control group. Face‐to‐face questionnaires, pulmonary function tests (PFT) and skin prick tests were applied to all the patients. If there was discordance between asthma history and PFT results, a methacholine bronchial provocation test (BPT) was performed. Results A total of 43 patients with ACE‐I induce cough were compared with 50 controls. Bronchial hyperreactivity (BHR), rhinitis, atopy and family history of asthma were more frequent in patients with ACE‐I induced cough (P < .001). Patients with ACE‐I‐induced cough had significantly higher incidence of diagnosed asthma [OR = 8.28 (95%CI: 3.26‐21.03) P < .001]. Conclusions Asthma and an atopic background constitute a substantial risk factor for ACE‐I induced cough. The presence of underlying asthma should be investigated in patients diagnosed with ACE inhibitor induced cough. However, the fact that most asthma patients tolerate ACE‐I therapy, indicates that other cofactors are likely involved.

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“…The most frequent adverse reaction to ACE-inhibitor therapy, coughing, arises more frequently in women than men: by a factor of _1.5-2. [109,110] In the opposite no gender-specific differences with respect to the occurrence of angioneurotic edemas or urticaria have been described under ACE-inhibitor therapy. [111] The cause of different gender-related effects of ACE-inhibitors observed in clinical trials are unknown.…”

Section: Ace-imentioning

confidence: 98%

Gender Related Issues in the Management of Heart Failure

Anker¹,

Caminiti²,

Volterrani³

2011

Current Pharmaceutical Design

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Heart failure (HF) represents a growing health issue with significant morbidity, expense, and mortality in western world. Despite a similar prevalence between gender our knowledge about this disease mostly come from studies performed in men. Instead, until now women have been under-represented in HF trials and this limits our knowledge of HF in women to extrapolation of findings from men. However according to the available data women with HF differ from men regarding pathophysiology, clinical presentation and prognosis. Women with HF often present at an older age, have a better systolic function, suffer from more comorbidities, have an higher rate of hospital admissions and have a better age-adjusted survival compared to men. Moreover pharmacodynamic specificities related to gender have been described. Taken together these gender-related differences can affect response to several kinds of treatments and the general clinical approach to the patient by the physician. The understanding of these differences may improve the clinical management of HF and possible new gender-specific diagnostic and therapeutic options may be developed. To this aim, it remains mandatory. to increase the number of female patients with HF enrolled in clinical trials.

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Cough during Treatment with Angiotensin Converting Enzyme Inhibitors

Cited by 24 publications

References 13 publications

Effect of smoking cessation on cough reflex sensitivity

Effect of smoking cessation on cough reflex sensitivity

The presence of underlying asthma should be investigated in patients diagnosed with ACE inhibitor induced cough

Gender Related Issues in the Management of Heart Failure

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