Iron Supplementation Inhibits Cough Associated With ACE Inhibitors

Lee, Sang‐Chol; Park, Seung Woo; Kim, Duk Kyung; Lee, Sang Hoon; Hong, Kyung Pyo

doi:10.1161/01.hyp.38.2.166

Cited by 31 publications

(21 citation statements)

References 31 publications

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“…As observed in an earlier study, 11 iron supplementation did not result in any significant change in mean haemoglobin concentration and haematocrit readings. There were no significant changes in blood urea, serum creatinine, serum sodium and potassium concentrations.…”

supporting

confidence: 84%

Attenuation of angiotensin converting enzyme inhibitor induced cough by iron supplementation: role of nitric oxide

Bhalla¹,

Singh

Ravindran³

2011

J Renin Angiotensin Aldosterone Syst

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The present study examined whether (1) the cough associated with angiotensin converting enzyme inhibitor therapy is attenuated by oral intake of iron and anti-oxidants, and (2) nitric oxide (NO) has any role in this attenuation. Of the 100 patients under investigation, cough occurred in 28 of them with preponderance in females. All the 28 patients were followed up for six weeks: the first two weeks were the observation period and the remaining four weeks the experimentation period. After the observation period, 11 patients received a single oral dose of ferrous sulphate (200 mg), eight received vitamin E (200 mg, o.d.) and vitamin C (150 mg, o.d.) and nine were given placebo during the experimentation period. Cough scoring, serum NO and malondialdehyde (MDA) levels were determined during both the periods. While there were significant decreases in cough scores, NO and MDA levels between these two periods in the iron group, cough scores and MDA level decreased significantly in the anti-oxidant group. None of these parameters changed in the control group. NO level was found to be increased significantly in patients who developed cough (n = 28) compared with those who did not cough (n = 72). These results suggest that iron supplementation suppresses cough in patients on ACE-I therapy through its effect on NO generation.

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supporting

confidence: 84%

Attenuation of angiotensin converting enzyme inhibitor induced cough by iron supplementation: role of nitric oxide

Bhalla¹,

Singh

Ravindran³

2011

J Renin Angiotensin Aldosterone Syst

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“…148 -150 One small study of Asian women has shown improvement or relief of cough with iron supplementation. 151 The mechanism for the increased incidence of cough is not elucidated although 1 report of Asian patients with cough that included mostly diabetic women, found an association with an ACE genetic polymorphism. 152…”

Section: Ace Inhibitorsmentioning

confidence: 99%

Gender-Specific Implications for Cardiovascular Medication Use in the Elderly

Schwartz

2003

Cardiology in Review

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Sex should be considered during the selection of cardiovascular medications and dosages of cardiovascular medications. There is mounting evidence that clinically important differences between the sexes exist in the pharmacokinetic processes that determine drug concentrations and in the pharmacodynamic processes that determine physiologic responses to pharmacologic agents. Although aging also affects these processes, aging does not eliminate the sex-related differences. The major pharmacokinetic differences between the sexes, on average, are lower weight and distribution volumes in women compared with men and lower renal drug clearance in women compared with men. Sex-related differences in hepatic drug clearance are less predictable. Pharmacodynamic responses that differ between the sexes include increased adverse cardiovascular drug effects in women compared with men (torsade de pointes arrhythmias, increased risk of hemorrhagic consequences of anticoagulation or thrombolytic therapy, electrolyte abnormalities with diuretics, myopathy with HMG Co-A reductase inhibitors, cough with ACE inhibitors, and increased incidence of thrombosis). Recommendations for optimizing cardiovascular drug therapy for the older women include individualization of drug selection to minimize the number of medications and side effects; dosage adjustment based on age, size, and sex; close monitoring for side effects; and consideration of cost and access to medications. Optimal care for the older woman with cardiovascular disease will also require investigation of cardiovascular medications in older women and of therapies for cardiovascular diseases that are more common in women than men.A lthough there is increasing evidence to support invasive and acute cardiac interventions in the elderly, most of therapeutic cardiac interventions for the elderly are pharmacologic. It is therefore important to periodically review evolving clinical concepts for drug selection and modifications for patient subgroups. Despite the underrepresentation of women in clinical investigations and cardiovascular clinical trials, 1-3 it is becoming clear that the response to medications may differ between the sexes. One striking example of the impact of sex differences in drug responses is highlighted by drug withdrawals from the US market during the period from 1997 until early 2001. Of the 10 drugs removed from marketing during that period, 4 were prescribed more frequently to women (for weight loss [dexfenfluramine as Redux and dexfenfluramine as Pondimin], for diabetes [troglitazone as Rezulin], and for inflammatory disease (Lotronex)] and 4 had higher rates of toxicity in women but were prescribed in equal rates to men and women (for hypertension [Mibefradil as Posicor] antihistamines [terfenadine as Seldane or Hismanal], heartburn [cisapride as Propulsid]. Two were prescribed in equal rates and had equal toxicity in men and women (grepafloxacin, an oral fluroquinolone antibiotic, as Raxar; and for pain relief, bromfenac as Duract). In later 2001, cerivastatin...

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“…Ferrous sulphate has also been shown to reduce ACEI‐induced cough, presumably through inhibition of nitric oxide synthesis 16 . However, while ferrous sulphate therapy had only reduced the severity of ACEI‐induced cough, noscapine could eliminate the cough altogether in the vast majority of patients.…”

Section: Discussionmentioning

confidence: 99%