Cough and ACE inhibitors

Moore, Nicholas; Noblet, C.; Joannidès, Robinson; Ollagnier, M.; Jl, Imbs; Lagier, G

doi:10.1016/0140-6736(93)92543-3

Cited by 20 publications

(11 citation statements)

References 2 publications

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“…The reasons for this are obscure. Studies on upper airway symptoms have revealed that women report symptoms of mucosal irritation more often than men [29], and cough as a side-effect of treatment with angiotensin-converting enzyme inhibitors is more often reported by women [30]. To our knowledge, the reasons for these discrepancies have not been elucidated.…”

Section: Questionnaire Findingsmentioning

confidence: 48%

Symptoms related to asthma and chronic bronchitis in three areas of Sweden

Björnsson¹,

Plaschke²,

Norrman³

et al. 1994

Eur Respir J

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S Sy ym mp pt to om ms s r re el la at te ed d t to o a as st th hm ma a a an nd d c ch hr ro on ni ic c b br ro on nc ch hi it ti is s i in n tWheezing was reported by 20.5%, and the combination of wheezing without a cold and wheezing with breathlessness by 7.4%. The use of asthma medication was reported by 5.3%. Long-term cough and/or morning cough together with problems with phlegm was reported by 12.8%; the prevalence being highest in the most polluted area (Göteborg). When using multivariate analysis, no significant difference in asthma-related symptoms was found between the centres. Women reported cough more frequently, but otherwise gender did not influence symptom prevalence.Our results indicate that bronchitis symptoms occur more frequently in Göteborg, the most polluted of the Swedish centres, but that the prevalence rates of asthmarelated symptoms do not differ between these three regions.

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Section: Questionnaire Findingsmentioning

confidence: 48%

Symptoms related to asthma and chronic bronchitis in three areas of Sweden

Björnsson¹,

Plaschke²,

Norrman³

et al. 1994

Eur Respir J

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“…This has been attributed to diagnostic bias [26], but our data suggest that it might be a manifestation of a greater ability of females to perceive bronchoconstriction. Sex differences in the perception of respiratory sensations might also explain other phenomena such as the female predominance in reporting respiratory side-ef-fects of angiotensin-converting enzyme-inhibitors in the absence of an excess of cardiovascular side-effects [27].…”

Section: Discussionmentioning

confidence: 99%

Perception of respiratory symptoms after methacholine-induced bronchoconstriction in a general population

Devereux¹,

Hendrick²,

Stenton³

1998

Eur Respir J

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In an epidemiological study, methacholine-induced bronchoconstriction was used as a physical illustration of the sensations associated with asthma. The objective of this study was to assess whether familiarity with these sensations could be used as a measure of asthma prevalence. Eight hundred and seventy six subjects aged 20-44 yrs completed a respiratory questionnaire and a measurement of airway responsiveness (the provocative dose of methacholine causing a 20% fall in forced expiratory volume in one second (PD20)). Subjects were asked about their perception of, familiarity with and description of the respiratory sensations experienced at the time of maximal bronchoconstriction. The questionnaire-derived lifetime prevalences of wheeze, chest tightness and undue breathlessness were 43, 35 and 22% respectively. Asthma medication was used by 8% and the lifetime prevalence of diagnosed asthma was 12%. Quantifiable levels of airway responsiveness were measured in 34%, and airway responsiveness in the range considered to be consistent with untreated active asthma was present in 21%. Bronchoconstriction was perceived by 59%. Perception of bronchoconstriction was associated with the magnitude of bronchoconstriction, younger age, female sex and questionnaire-reported symptoms. Of subjects able to perceive bronchoconstriction, 58% reported previous experience of (familiarity with) the associated respiratory sensations. Familiarity with the sensations of bronchoconstriction was associated with questionnaire-reported symptoms, diagnosed asthma and increasing levels of airway responsiveness. There was poor agreement between the respiratory symptoms reported by questionnaire before the methacholine test and the words used to describe respiratory sensations induced by the test. Familiarity with the sensations of methacholine-induced bronchoconstriction has all the appropriate associations of a measure of asthma prevalence and may be a useful adjunct to symptom questionnaires and airway responsiveness measurements in epidemiological studies. A sizeable number of subjects can be identified with intermediate levels of airway responsiveness, who are able to perceive bronchoconstriction and are familiar with the sensations associated with it, yet who are not recognized to suffer from asthma.

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“…The frequency of cough has been reported to be higher in women and nonsmokers for unexplained reasons. [17][18][19] There have been various reports that have tried to explain the mechanism of this side effect. Bradykinin and prostaglandins are the most frequently proposed causes of the cough, 4,5 and many studies using nonsteroidal anti-inflammatory drugs, such as sulindac and indomethacin, have been undertaken to attempt to abolish this side effect and thus allow continued medication.…”

Section: Discussionmentioning

confidence: 99%

Iron Supplementation Inhibits Cough Associated With ACE Inhibitors

et al. 2001

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Abstract-Dry cough is the most common limiting factor of ACE inhibitor (ACEI) use. Generation of NO, a proinflammatory substance on bronchial epithelial cells, is increased by ACEI. Using a randomized, double-blind, placebo-controlled trial, we tested the hypothesis that supplementing iron, an inhibitor of NO synthase, may reduce the cough associated with ACEI use. The subjects were 19 patients who had developed ACEI-induced cough. After a 2-week observation period, they were randomized to a daily morning dose of either 256-mg ferrous sulfate as a tablet or placebo for a treatment period of 4 weeks. The subjects were requested to fill out a cough diary by scoring the daily severity of the cough on a scale of 0 to 4. Mean daily cough scores for the last week of the observation and treatment period were compared. Changes in blood cell count and serum iron and ferritin concentration between the 2 periods were evaluated. Mean daily cough scores during the observation and treatment periods were 3.07Ϯ0.70 and 1.69Ϯ1.10, respectively, for the iron group and 2.57Ϯ0.80 and 2.35Ϯ1.22, respectively, for the placebo group, showing a significant reduction in cough scores with iron supplementation (PϽ0.01) but not with placebo. Three subjects in the iron group showed almost complete cough abolition. No significant changes in laboratory data were observed in either group. In conclusion, iron supplementation successfully decreases ACEI-induced cough. This effect may be related to the decrease of NO generation associated with the inhibition of NO synthase activity in bronchial epithelial cells.

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Cough and ACE inhibitors

Cited by 20 publications

References 2 publications

Symptoms related to asthma and chronic bronchitis in three areas of Sweden

Symptoms related to asthma and chronic bronchitis in three areas of Sweden

Perception of respiratory symptoms after methacholine-induced bronchoconstriction in a general population

Iron Supplementation Inhibits Cough Associated With ACE Inhibitors

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