Persistent dry cough with enalapril: incidence depends on method used

Area of Science:

• Pharmacology
• Clinical Medicine
• Cardiology

Background:

• Hypertension is a prevalent cardiovascular condition requiring pharmacologic management.
• Angiotensin-converting enzyme (ACE) inhibitors, such as enalapril, are widely prescribed for hypertension.
• Adverse drug reactions, including cough, can impact treatment adherence and patient outcomes.

Purpose of the Study:

• To determine the incidence of persistent dry cough in patients initiating enalapril therapy.
• To investigate factors associated with enalapril-induced cough.
• To assess the impact of cough on enalapril treatment discontinuation.

Main Methods:

• A cohort of 136 hypertensive patients receiving enalapril was prospectively followed.
• Life-table analysis was employed to calculate the cumulative incidence of dry cough.
• Incidence rates were analyzed in relation to patient demographics, clinical factors, and treatment parameters.

Main Results:

• The overall incidence of persistent dry cough was 14.6%, with women experiencing twice the rate observed in men.
• Dry cough was not significantly associated with age, smoking status, renal function, or enalapril dosage/duration.
• Cough necessitated enalapril discontinuation in 6.0% of patients, representing the primary reason for withdrawal.

Conclusions:

• Persistent dry cough is a common and significant side effect of enalapril treatment.
• Previous studies likely underestimated the true incidence of enalapril-induced cough.
• Clinicians should be aware of the high incidence of cough and its impact on treatment adherence in hypertensive patients.