a Department of Internal Medicine , International University of Health and Welfare Mita Hospital , Tokyo , Japan.
Clin Exp Hypertens. 2015;37(7):563-8. doi: 10.3109/10641963.2015.1026040. Epub 2015 May 20.
Angiotensin converting enzyme (ACE) inhibitors are reportedly effective, and positively indicated in patients with chronic heart failure with decreased contractility, after myocardial infarction, after cerebrovascular disorders, and in those with chronic kidney disease. However, the biggest challenge to continuous use of ACE inhibitors is the adverse reaction of cough. Accordingly, in the present study, we investigated the present state and characteristics of ACE inhibitor-induced cough in patients with essential hypertension currently being treated with an ACE inhibitor for an average of 18 months, who could be regularly checked for cough. Subjects in this study were 176 patients overall (mean age 67 ± 11 years old), 90 men and 86 women. The adverse reaction of cough was observed in 20% of patients, and more frequently in women than in men. However, in 26 of the patients with cough, the cough either resolved naturally or completely disappeared while the treatment continued, after which patients could continue taking the medication. Specifically, ACE inhibitor treatment was eventually discontinued due to cough in 5.1% of patients. Cough occurred less frequently with concomitant calcium antagonists or diuretics than with ACE inhibitor monotherapy. Cough as an adverse reaction occurred at a low frequency when medication was taken at bedtime. We considered a number of measures to counteract cough, then in addition to starting the ACE inhibitor treatment as early as possible, it is important to devise ways for the ACE inhibitor treatment to be continued for as long as possible, through the adept use of these measures.
血管紧张素转换酶（ACE）抑制剂据称对心肌梗死后、脑血管疾病后和慢性肾脏病患者等收缩功能下降的慢性心力衰竭患者有效，并呈阳性。然而，连续使用 ACE 抑制剂的最大挑战是咳嗽的不良反应。因此，在本研究中，我们调查了目前正在使用 ACE 抑制剂治疗的原发性高血压患者中 ACE 抑制剂诱导性咳嗽的现状和特征，这些患者平均使用 ACE 抑制剂治疗了 18 个月，可定期检查咳嗽。本研究的受试者共有 176 人（平均年龄 67±11 岁），其中男性 90 人，女性 86 人。20%的患者出现了咳嗽不良反应，女性比男性更常见。然而，在 26 名咳嗽患者中，咳嗽自然缓解或完全消失，且在继续治疗后，患者可以继续服用药物。具体来说，由于咳嗽，有 5.1%的患者最终停止了 ACE 抑制剂治疗。与 ACE 抑制剂单药治疗相比，同时使用钙拮抗剂或利尿剂时咳嗽的发生率较低。睡前服药时，咳嗽作为不良反应的发生率较低。我们考虑了一些对抗咳嗽的措施，除了尽早开始 ACE 抑制剂治疗外，还重要的是通过巧妙地使用这些措施，尽可能长时间地继续 ACE 抑制剂治疗。
