💊 Enalapril: Why Does It Cause a Cough?

Enalapril is an angiotensin-converting enzyme inhibitor (ACE inhibitor) that has revolutionized the treatment of hypertension and other cardiovascular diseases such as coronary artery disease and heart failure. The history of enalapril begins in the 1930s when Brazilian scientist Sergio Ferreira was studying the effects of the jararaca snake venom. Ferreira discovered that the venom contained a substance that could block the action of angiotensin II, a hormone that contributes to high blood pressure. This discovery marked the beginning of a long journey towards developing an effective medication.

It is a medication that has been shown to reduce death, heart attacks, and strokes in high-risk patients such as those with diabetes (HOPE trial). Additionally, it has also been shown to reduce the progression of kidney damage and kidney failure, a severe complication of diabetes (micro HOPE trial).

What is the most common side effect that leads to its discontinuation?
Cough is the most common side effect; between 7% and 10% of those treated with this medication experience a dry cough. It can be described as insidious, dry, persistent, benign, and reversible upon discontinuation of the treatment. It is important to distinguish enalapril-induced cough from cough resulting from an acute illness, reactive airway disease, and congestive heart failure. It is more frequent in women (a little more than twice as much) than in men and is caused by an increase in substances that produce inflammation of the upper airway. It is a dry and bothersome cough but poses no risk.

🩺 Of course, it is important for each patient to consult their cardiologist to review in detail and obtain the best treatment for their cardiovascular condition.

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