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

İnsu Yılmaz, Murat Türk, Burcu Baran Ketencioğlu, Zeki Çetinkaya, Nuri Tutar, Fatma Sema Oymak, İnci Gülmez, Newton Franklin Adkinson

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)382-388
Number of pages7
JournalClinical Respiratory Journal
Volume14
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • ACE-inhibitor induced cough
  • angiotensin converting enzyme inhibitors
  • asthma
  • bronchial hyperreactivity
  • cough
  • hypertension

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Genetics(clinical)

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