The safety and acceptability of perindopril

Angiotensin converting enzyme (ACE) inhibitors are becoming increasingly used in the treatment of hypertension. Although they are generally well tolerated, they have been implicated in the occurrence of certain side effects such as cough, hypotension and deterioration of renal function. These have been investigated prospectively during the development of perindopril. In a long term study in 632 hypertensive patients 6% of subjects stopped treatment prematurely because of adverse events and cough was the side effect most frequently responsible for treatment withdrawal (1.3%). A typical ACE inhibitor-induced cough was seen in a further 1.6% of patients. Symptomatic hypotension was rarely reported (0.2%), even in the elderly and patients with congestive heart failure. No clinically significant changes in plasma creatinine or potassium levels were seen during the long-term administration of perindopril in uncomplicated hypertensive patients. The overall safety profile of perindopril in clinical studies was favourable even in groups of more vulnerable patients. However the effect of long-term treatment with ACe inhibitors on cardiovascular morbidity and mortality is unknown.