Dry Cough Due to ACE Inhibitors

Angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed to treat cardiovascular conditions like congestive heart failure (CHF) and hypertension. ACE inhibitors work by lowering the production of angiotensin II, a neurohormone that causes blood vessels to constrict and the kidneys to retain sodium and fluid--both of which adversely affect cardiovascular function.

Side Effects

• A dry cough is a common side effect reported by people taking ACE inhibitors, and the primary reason patients discontinue ACE inhibitor therapy.

Cause

• According to Kyung Pyo Hong, M.D., of the Samsung Medical Center in Seoul, South Korea, doctors don't fully understand why ACE inhibitors often produce a dry cough.

Theories & Speculation

• According to Dr. Hong, as many as 39 percent of patients using ACE inhibitors experience the dry cough as a side effect.

Expert Insight

• In a study led by Dr. Hong, researchers recruited 19 patients taking ACE inhibitors. All had dry coughs. Half the group received 256 milligrams of ferrous sulfate (iron) daily for four weeks, while the other half received a placebo. The iron group reported half the amount of coughing after using the iron, while the placebo group had no significant change.

Alternatives

• For people who can't tolerate the cough associated with ACE inhibitors, Angiotensin II Receptor Blockers (ARBs) might be an alternative option. ARBs also block angiotensin II, but don't cause a dry cough.