Key result
ACEi cough rates vary by individual agent, suggesting switching may be preferable to discontinuation.
Why the study?
ACEi are cardioprotective but can cause dry cough, with widely varying incidence and mechanisms among individual agents that complicate clinical management.
ACEi-induced cough may not be a class effect, and switching to an alternative ACEi with high tissue affinity (like perindopril) or performing a challenge/re-challenge may prevent inappropriate discontinuation of cardioprotective therapy.
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Variable ACEi cough incidence may support switching over discontinuation; leaves open prospective validation of adherence benefits.
Borghi et al. (2023) conducted a review in ACEi-induced cough. Angiotensin-converting enzyme inhibitors (ACEi) was evaluated on Incidence of ACEi-induced cough. Angiotensin-converting enzyme inhibitors (ACEi) are associated with a variable incidence of cough among individual agents, suggesting patients may benefit from switching ACEi rather than discontinuing.
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