Key result
ACEI-induced cough occurred in 24.5% of hypertensive patients and disappeared in an average of 6.06 days after discontinuation, with female sex (OR 1.77) and OSA (OR 1.85) as predisposing factors.
Why the study?
The time required for an ACEI-induced cough to resolve after drug discontinuation and the factors predisposing to the cough and angioneurotic edema were not well defined.
Cohort (n=1,101)
Answers are grounded in this paper and cite their sources.
ACEI-induced cough typically resolves within 10 days of discontinuation and is more likely to occur in females, patients with obstructive sleep apnea, and those on concomitant thiazides.
Our main objective was to investigate the numbers of days necessary for the disappearance of the cough caused by an angiotensin-converting enzyme inhibitor (ACEI) subsequent to the discontinuation of treatment, and to identify the associated factors that contribute to the appearance of said cough and angioneurotic edema. We studied 1101 patients with hypertension treated with an ACEI for 15 years. A multivariate analysis of binary logistic regression was performed to identify predisposing cough factors. In the 1101 patients treated with ACEI, 270 were diagnosed as having a cough caused by an ACEI (24.5%). The average numbers of days until the cough disappeared was 6.06 ± 1.58 days. The significant predisposing factors of the cough were female sex (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.31-2.39), previous diagnosis of obstructive sleep apnea (OR, 1.85; 95% CI, 1.31-2.61), and concomitant use of thiazides (OR, 1.50; 95% CI, 1.11-2.04). Statins were shown as a protective factor (OR, 0.69; 95% CI, 0.51-0.93). In the case of angioneurotic edema, 25 patients (2.3%) were diagnosed, without significant determinants. Our analysis showed that the cough disappeared in a period of ≤10 days for 96.7% of patients diagnosed with a cough, subsequent to the discontinuation of ACEI treatment. The risk factors identified for the appearance of a cough include female sex, previous obstructive sleep apnea, and concomitant use of thiazides. The use of statins was found to be a protective factor. The incidence of angioneurotic edema in our cohort is greater than that described in the literature.
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Fernandez‐Rando et al. (2020) conducted a cohort in hypertension (n=1,101). Angiotensin-converting enzyme inhibitor (ACEI) was evaluated on days until the cough disappeared after discontinuation of ACEI treatment. ACEI-induced cough occurred in 24.5% of hypertensive patients and disappeared in an average of 6.06 days after discontinuation, with female sex (OR 1.77) and OSA (OR 1.85) as predisposing factors.
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