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Related Experiment Videos

Cough due to ACE inhibitors: a case-control study using automated general practice data

L E Visser1, A E Vlug, J van der Lei

  • 1Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.

European Journal of Clinical Pharmacology
|January 1, 1996
PubMed
Summary

Angiotensin-converting enzyme (ACE) inhibitors may increase cough risk, though this risk diminishes with longer treatment duration. This study investigated ACE inhibitor-induced cough in a large population, finding the association weakened after adjusting for confounding factors.

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Area of Science:

  • Pharmacovigilance
  • Clinical Pharmacology
  • Epidemiology

Background:

  • Cough is a known adverse reaction to ACE inhibitors.
  • Understanding the real-world risk and influencing factors is crucial for patient safety.

Purpose of the Study:

  • To determine the risk of cough as an adverse reaction to ACE inhibitors in a large population.
  • To investigate if the adverse effect of cough is dependent on the duration or dose of ACE inhibitor treatment.

Main Methods:

  • A population-based case-control study was conducted.
  • Data were collected from ten general practices in the Netherlands over 18 months.
  • 1458 patients with new-onset cough were compared with 4182 matched controls, excluding those with respiratory infections or other relevant conditions.

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Main Results:

  • Patients using ACE inhibitors were more likely to experience cough (crude OR 2.1).
  • After adjustment, the odds ratio for cough associated with ACE inhibitors was 1.4 (95% CI 0.9-2.1).
  • The risk of cough was highest for short-term ACE inhibitor use (≤2 months, OR 4.8) and decreased with longer treatment durations.

Conclusions:

  • ACE inhibitor use is associated with an increased risk of cough, although significance diminishes after controlling for confounders.
  • The risk of developing ACE inhibitor-induced cough appears to decrease over time, potentially due to the elimination of susceptible individuals.
  • Specific ACE inhibitors like enalapril showed a higher adjusted odds ratio for cough compared to others.