The incidence of cough during treatment with angiotensin converting enzyme inhibitors

Strocchi, Enrico; Valtancoli, Gianpaolo; Ambrosioni, Ettore

doi:10.1097/00004872-198900076-00150

Cited by 28 publications

(8 citation statements)

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“…The 20% prevalence of cough observed in men at 6 months in this study was considerably higher than that generally reported (Berkin & Ball, 1988;Just, 1989). In common with clinic-based studies (Gibson, 1989;Hood et al, 1987;Strocchi et al, 1989;Town etal., 1987;) enalaprilinduced cough was more common in women than men. This difference was large and statistically significant after 8 weeks treatment, but much less marked after 24 weeks.…”

Section: Discussionsupporting

confidence: 70%

“…The incidence or prevalence of dry cough with ACE inhibitors depends greatly on the method of ascertainment . Taking enalapril as an example, postmarketing surveillance studies have reported an incidence of about 3% (Coulter & Edwards, 1987;Inman etal., 1988), whereas hospital clinic surveys have revealed a much higher incidence ranging from 6.3-14.6% (Gibson, 1989;Hood et al, 1987;Strocchi et al, 1989;Town et al, 1987;. In a recent controlled hospital-based survey the prevalence of persistent cough during prolonged treatment with enalapril averaging 27 months was 15.9% higher (95% CI 7.2-24.6%) than that in matched nifedipine-treated patients .…”

Section: Introductionmentioning

confidence: 99%

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Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Yeo

Maclean

Richardson

et al. 1991

Brit J Clinical Pharma

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The incidence and prevalence of cough related to enalapril was assessed by spontaneous reporting and a visual analogue scale during a 6 month random double-blind parallelgroup study comparing enalapril with nifedipine. Cough was reported spontaneously by 6.2% of enalapril-treated patients, and by none on nifedipine (NS). No patient had to discontinue enalapril because of cough. After 24 weeks treatment increases in visual analogue scale scores for cough frequency -8 mm were more common for enalapril than nifedipine (difference 21.5%, 95% CI 7.3-35.7%). Increased cough frequency by visual analogue scale was present throughout the study in women, but less consistently in men. High scores for cough were not related to the dose of enalapril. Cough with enalapril was not an important problem during the 6 months of treatment. However increased cough frequency could be detected by visual analogue scale, with a frequency consistent with that observed in open clinic-based studies of longer duration. These findings suggest that ACE inhibitor-induced cough may increase in severity over time, and that even a period of 6 months treatment is too short to evaluate this side-effect adequately.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Yeo

Maclean

Richardson

et al. 1991

Brit J Clinical Pharma

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“…Gender was not a matched variable for this study and the gender proportions of the two cohorts were opposite; Cooper et al [11] found similar proportions. Gender differences (with females predominating) in the prevalence of the ACE inhibitor induced cough have been reported by several clinic based studies [4,7,[12][13][14], and one PMS study [1]. In our study the prevalence of cough and bronchospasm reactions in females was not statistically different from the 54% predominance of women in the entire ACE inhibitor cohort.…”

Section: Discussioncontrasting

confidence: 43%

Bronchospasm and cough as adverse reactions to the ACE inhibitors captopril, enalapril and lisinopril. A controlled retrospective cohort study.

Wood

1995

Brit J Clinical Pharma

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1 We report a controlled retrospective cohort study of respiratory adverse reactions to ACE inhibitors. Bronchospasm and cough occurred at a higher rate in patients treated with ACE inhibitors, no links with sex, past history of bronchospasm, drug type or dose were found. 2 Cohorts of 1013 patients on angiotensin converting enzyme (ACE) inhibitors and 1017 patients on lipid lowering drugs (LLDs) were compared for the occurrence of new bronchospasm, relapse of previous bronchospasm, increase of current bronchospasm, and cough. 3 The prevalence of bronchospasm was 5.5% for patients on ACE inhibitors and 2.3% for patients on LLDs, P < 0.001. The relative risk of a bronchospasm adverse reaction for a patient on an ACE inhibitor compared with a patient on a LLD was 2.39, 95% confidence interval 1.47 to 3.90. 4 No ACE inhibitor specificity, or significant sex differences were found in the prevalence of bronchospasm or cough after correcting for bias implicit in the original cohorts. The bronchospastic reactions were not dose dependent. 5 The prevalence of a past history of bronchospasm in patients reporting ACE inhibitor-induced bronchospasm (16%) was not significantly different from the prevalence in patients on ACE inhibitors without an adverse reaction (13%), P = 0.447. 6 The prevalence of ACE inhibitor cohort cough was 12.3% and 2.7% in the patients on LLDs, P < 0.0001. Cough did not occur more commonly in patients on ACE inhibitors who had experienced any bronchospasm (28%) than in patients on LLDs with bronchospasm (27%).

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“…Cough is a well documented side effect of ACE inhibitors and an expected adverse event for moexipril in the whole population. [34][35][36][37] Although the ability is limited to extrapolate the findings to other HRT groups than those examined, this study indicates that moexipril is effective and well-tolerated in the treatment of hypertensive, postmenopausal women and can safely be co-administered to individuals taking HRT. Nevertheless, the interaction of ACE inhibition and HRT during longterm administration in postmenopausal women remains an outstanding topic which requires further research.…”

Section: Discussionmentioning

confidence: 83%

Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

1999

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Co-administration of antihypertensive drug therapy and hormonal replacement therapy (HRT) is frequent in postmenopausal women but it is not known whether HRT interacts with concomitant antihypertensive therapy. The present study was designed to investigate efficacy and safety of the ACE inhibitor moexipril in comparison to placebo in hypertensive, postmenopausal women on HRT.After a 4-week placebo run-in phase, 95 postmenopausal women (35-74 years of age) who had a sitting diastolic blood pressure (BP) of 95-114 mm Hg and were treated with HRT were randomised to a 12-week treatment with moexipril 15 mg or placebo. Efficacy and safety were assessed by measuring changes in sitting BP and metabolic parameters associated with cardiovascular disease including triglycerides, total cholesterol, HDL, LDL, total cholesterol/HDL ratio and glucose. Adverse events were recorded continuously.After 12 weeks of treatment, moexipril 15 mg was significantly more effective in reducing sitting systolic

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The incidence of cough during treatment with angiotensin converting enzyme inhibitors

Cited by 28 publications

References 0 publications

Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Bronchospasm and cough as adverse reactions to the ACE inhibitors captopril, enalapril and lisinopril. A controlled retrospective cohort study.

Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

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