Airway responsiveness and cough induced by angiotensin converting enzyme inhibition

Dry cough is one of the most common side-effects of angiotensin converting enzyme inhibitors. The mechanism of cough induced by ACE inhibitors is not completely understood and may be related to bronchial hyperreactivity and/or an accumulation of kinins. In a placebo-controlled, double-blind randomis...

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Bibliographic Details
Published inJournal of human hypertension Vol. 6; no. 5; p. 387
Main Authors Overlack, A, Müller, B, Schmidt, L, Scheid, M L, Müller, M, Stumpe, K O
Format Journal Article
LanguageEnglish
Published England 01.10.1992
Subjects
Adult
Airway Resistance
Angiotensin-Converting Enzyme Inhibitors - adverse effects
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Asthma - drug therapy
Asthma - physiopathology
Bradykinin
Bronchi - drug effects
Bronchi - physiopathology
Bronchial Provocation Tests
Captopril - adverse effects
Captopril - therapeutic use
Cough - chemically induced
Double-Blind Method
Histamine
Humans
Hypertension - drug therapy
Hypertension - physiopathology
Lung - drug effects
Lung - physiopathology
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Summary:Dry cough is one of the most common side-effects of angiotensin converting enzyme inhibitors. The mechanism of cough induced by ACE inhibitors is not completely understood and may be related to bronchial hyperreactivity and/or an accumulation of kinins. In a placebo-controlled, double-blind randomised study, the effect of captopril on lung function and bronchial reactivity to histamine and bradykinin was investigated in eight asthmatic and 12 hypertensive patients (six with and six without cough during previous ACE inhibition). Lung function did not change in any patient after a single (25 mg) or short-term (2 x 25 mg for two weeks) administration of captopril. Bronchial reactivity to histamine and bradykinin remained unaltered in all groups. In hypertensive patients with cough, reactivity to histamine tended to be more pronounced and bronchial hyperreactivity to be more frequent than in those without cough. In conclusion, the present results do not support a major role for kinins in cough induced by ACE inhibition. On the other hand, bronchial hyperreactivity may be important in some patients. Additionally, these results demonstrate that treatment with ACE inhibitors is safe in most patients with bronchial asthma.
ISSN:0950-9240