ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR AND THE OCCURRENCE OF COUGH - A RETROSPECTIVE STUDY OF ALACEPRIL, CAPTOPRIL AND ENALAPRIL

The present study investigated the occurrence of cough with three different ACE inhibitors (alacepril, captopril and enalapril) in 203 patients with essential hypertension. Cough occurred in 12.5%, 27.3% and 23.2% of patients with alacepril, captopril and enalapril, respectively. The incidence of cough was significantly lower with alacepril than with the other two drugs, even after adjustment for the difference in the duration of administration for each drug. The interval between the start of administration and occurrence of cough was widely variable, ranging from 2 to 76 weeks with means (+/- SEs) of 8.0 +/- 2.1, 13.5 +/- 2.2 and 22.4 +/- 1.6 weeks for alacepril, captopril and enalapril, respectively; the interval was significantly shorter with alacepril than with the other two drugs. When alacepril was administered after a drug-free period to patients who had experienced cough with captopril or enalapril, cough did not occur in 64.3% of patients. We studied the possible relation between occurrence of cough and background factors including sex, age, dose and concomitant drugs, but none was found to be related to the occurrence of cough.