Captopril induced cough : incidence in basrah-iraq and characterization of patients

Abstract EN

Objectives : Cough induced by angiotensin converting enzyme inhibitors is a well-known phenomenon.

It seems to be racially dependent as its incidence is reportedly much higher in the Chinese and Japanese populations compared to the European population.

The objective of this report was to study, for the first time, its incidence in the local population of Basrah (Iraq) and also to characterize those patients who develop cough.

Methods: 148 patients who received the ACE inhibitor captopril through the pharmacies of public clinics were interviewed to estimate the incidence of cough.

92 patients consulting specialists in internal medicine at private clinics were studied to characterize patients who develop cough.

Results : The incidence of captopril-induced cough in the 148 patients interviewed at the public clinic was 40.5%.

Cough was commonly described as irritation in the throat.

To characterize the type of patient susceptible to developing this kind of cough, 40 patients on captopril consulting specialists at private clinics and diagnosed as having cough attributed to captopril were compared with another 52 patients on captopril consulting the same specialists but without cough.

Cough was found to occur in females more than males with a female to male ratio of 2:1.

Its occurrence was not related to the dose of captopril and did not occur immediately after the start of treatment.

More than half of the patients (57.6%) developed their cough within the first month and more than 90% within the first 3 months from the start of captopril treatment.

Concomitant therapy showed interesting trends.

Patients with cough were less likely to take Moduretic, isosorbide dinitrate and glibenclamide and more likely to take atenolol andfrusemide than patients without cough.

Conclusion : The incidence of captopril-induced cough determined in the Basrah patients is high, approaching that reported in Chinese and Japanese studies.

The effect of concomitant therapy noted might stimulate an interest in conducting further trials to clarify any possible connection.