Shafique Ahmed, Muhammad Bilal Ahsan Qureshi, Muhammad Kashif Chaudhry, Muhammad Usman Ghani.
Comparative study of frequency of cough with Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Hypertension.
Pak J Cardiol Jan ;15(2):68-73.

Background-Hypertension is an important factor in premature death and contributes to several of the leading causes of the death including heart diseases, stroke and renal diseases. The effect of ACEIs` and ARBs` was studied for the development of cough beyond blood pressure control. Setting - Outpatient Department of Cardiology and Medicine Bahawal Victoria Hospital, Bahawalpur attached with Quaid-eAzam Medical College Bahawalpur. Method - Two hundred male patients with uncomplicated mild to moderate essential hypertension were randomized to the treatment with ACEIs` and ARBs` for a mean period of twelve weeks. During each treatment period, the incidence of cough which necessitated the withdrawl of drug, was studied after fulfilling the inclusion and exclusion criteria. Results - Two hundred male patients who were randomized to receive the drugs having mean age of 51.9 years, mean systolic blood pressure 164.55 mmHg and mean diastolic blood pressure 99.55 mmHg. The mean dose of enalapril was 13 mg and the mean dose of losartan potassium was 65 mg. After treatment of 12 weeks, mean systolic blood pressure was 124.55 mmHg and mean diastolic blood pressure was 92.55 mmHg. 25 patients (25%) with ACEIs` developed cough while 4 patients (4%) developed cough with ARBs` with significant difference of incidence of cough with <0.001. Conclusion - Now that numerous agents are available to manage hypertension, more research should be directed towards improving the compliance of patients with anti hypertensive therapy with less side effect profile. ARBs` may be preferred over ACEIs` in certain cases.

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