29432
document
Bradykinin-induced cough reflex markedly increases in patients with cough associated with captopril and enalapril . We studied the effects of angiotensin converting enzyme ( ACE ) inhibitors on cough responses to bradykinin ( BK ) , substance P ( SP ) and citric acid in a double blind , random study on 10 hypertensive patients receiving ACE inhibitors . Of these patients , five had reported cough with ACE inhibitors . Cough responses to citric acid were similar between patients with and without cough , and SP up to 10 ( -5 ) M did not cause cough in any of the subjects . BK caused cough at 13.4 +/- 1.2 ( -log M ) in 5 patients with cough associated with ACE inhibitors , but it did not cause cough at concentrations up to 10 ( -5 ) M in other 5 patients . One month after the withdrawal of ACE inhibitors , 5 patients were free from cough symptoms , and BK did not cause cough up to 10 ( -5 ) M in these patients , except for one who coughed at 10 ( -9 ) M , without changes in responses to citric acid . BK caused cough at 14.3 +/- 0.7 ( -log M ) although BK1-7 , a major metabolite of BK by ACE , caused cough at 5.7 +/- 0.7 ( -log M ) in another 3 patients with cough associated with ACE inhibitor . These results suggest that impaired metabolism of BK induced by ACE inhibitors may relate to the manifestation of cough in hypertensive patients receiving ACE inhibitors .
29433
Intervention_Pharmacological
angiotensin converting enzyme ( ACE ) inhibitors
29434
Intervention_Pharmacological
cough responses to bradykinin ( BK )
29435
Intervention_Pharmacological
substance P ( SP )
29436
Intervention_Pharmacological
citric acid
29437
Intervention_Pharmacological
ACE inhibitors
29438
Intervention_Pharmacological
ACE inhibitors
29439
Intervention_Pharmacological
BK
29440
Intervention_Pharmacological
ACE inhibitors
29441
Outcome_Physical
cough responses
29442
Outcome_Physical
cough
29443
Outcome_Physical
cough
29444
Outcome_Physical
cough symptoms
29445
Outcome_Physical
cough
29446
Outcome_Physical
cough
29447
Outcome_Physical
cough
29448
Participant_Condition
cough associated with captopril and enalapril
29449
Participant_Sample-size
10
29450
Participant_Condition
hypertensive
29451
Participant_Sample-size
five
29452
Participant_Condition
cough
29453
Participant_Sample-size
5
29454
Participant_Sample-size
5
29455
Participant_Sample-size
5