WHY ACE INHIBITORS CAUSE COUGH: SIDE-EFFECTS, TREATMENT, AND ALTERNATIVE OPTIONS

Angiotensin-converting enzyme (ACE) inhibitors, a common medication for hypertension and heart failure, can be a lifesaver for many people – but they can also cause a bothersome cough in up to 20% of people taking them. Why does this happen and what can be done about it? Let's dive into the causes, solutions, and alternatives to ACE inhibitors to help you find relief.

Understanding ACE Inhibitors and Their Mechanism

ACE inhibitors work by blocking the action of angiotensin-converting enzyme, which helps to lower blood pressure and improve blood flow. They are often prescribed for high blood pressure, congestive heart failure, and kidney disease.

How ACE Inhibitors Cause Cough

The exact mechanism behind the ACE inhibitor-induced cough is not fully understood, but several theories exist:

• Bradykinin Accumulation: ACE inhibitors increase the levels of bradykinin, a substance that can irritate the airways and cause a cough.
• Increased Substance P: ACE inhibitors also increase the production of substance P, another compound that stimulates coughing.
• Direct Irritation: ACE inhibitors can directly irritate the mucous membranes in the airways, leading to a cough.

Risk Factors for ACE Inhibitor-Induced Cough

Some people are more likely to experience a cough from ACE inhibitors than others. These include:

• Women: Women are more likely than men to develop a cough from ACE inhibitors.
• Older Adults: The risk of developing a cough increases with age.
• Smokers: Smokers are more likely to develop a cough from ACE inhibitors.
• People with a History of Asthma or Allergies: People with a history of asthma or allergies are more likely to develop a cough from ACE inhibitors.

Managing the ACE Inhibitor-Induced Cough

If you experience a cough from an ACE inhibitor, there are several things you can do to manage it:

• Talk to Your Doctor: Your doctor may recommend switching to a different ACE inhibitor or reducing your dosage.
• Try a Cough Suppressant: Over-the-counter cough suppressants, such as dextromethorphan or guaifenesin, may help to relieve your cough.
• Stay Hydrated: Drinking plenty of fluids can help to soothe your throat and reduce coughing.
• Use a Humidifier: A humidifier can help to add moisture to the air and reduce irritation in your throat.

Alternative Medications for Hypertension and Heart Failure

If you cannot tolerate ACE inhibitors due to a persistent cough, several alternative medications are available for hypertension and heart failure:

• Angiotensin Receptor Blockers (ARBs): ARBs work similarly to ACE inhibitors, but they do not cause a cough in most people.
• Calcium Channel Blockers: Calcium channel blockers work by relaxing the blood vessels, which helps to lower blood pressure.
• Diuretics: Diuretics work by increasing urine output, which helps to lower blood pressure.
• Beta-Blockers: Beta-blockers work by slowing the heart rate and reducing blood pressure.

Conclusion

ACE inhibitors are effective medications for hypertension and heart failure, but they can cause a cough in some people. If you experience a cough from an ACE inhibitor, there are several things you can do to manage it. Talk to your doctor about switching to a different ACE inhibitor or reducing your dosage. You can also try a cough suppressant, stay hydrated, use a humidifier, or try alternative medications. With the right treatment, you can manage your cough and still enjoy the benefits of ACE inhibitors.

FAQs

1. Q: What is the most common side effect of ACE inhibitors?
   A: The most common side effect of ACE inhibitors is a dry, hacking cough.

2. Q: Who is most likely to experience a cough from ACE inhibitors?
   A: Women, older adults, smokers, and people with a history of asthma or allergies are more likely to experience a cough from ACE inhibitors.

3. Q: What can I do to manage the cough caused by ACE inhibitors?
   A: You can talk to your doctor about switching to a different ACE inhibitor or reducing your dosage. You can also try a cough suppressant, stay hydrated, use a humidifier, or try alternative medications.

4. Q: What are some alternative medications for hypertension and heart failure?
   A: Alternative medications for hypertension and heart failure include angiotensin receptor blockers (ARBs), calcium channel blockers, diuretics, and beta-blockers.

5. Q: Can I prevent a cough from ACE inhibitors?
   A: There is no sure way to prevent a cough from ACE inhibitors. However, if you are at risk of developing a cough, your doctor may start you on a lower dose of ACE inhibitor or prescribe a different medication.