✅ Cough tablets from hypertension
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Cough as a side effect when taking antihypertensive therapy: pathophysiology and clinical relevance
Cough is a relatively common side effect in the treatment of arterial hypertension, in particular in connection with the use of certain anti-hypertensive drugs. This article examines the relationships between the use of Hypertension drugs, and the Occurrence of a chronic cough, sheds light on the possible pathophysiological mechanisms, and discusses diagnostic and therapeutic strategies.
Prevalence and relevant substance classes
A drug-induced cough occurs mainly in the treatment with ACE inhibitors (Angiotensin‑converting enzyme inhibitors). This group includes agents such as Enalapril, Ramipril and Lisinopril. According to studies, approximately 5-20% of patients on ACE inhibitors develop a dry, irritating cough. Less often, a cough with other anti-hypertensive substances is brought in connection with this, including beta-blockers or calcium channel blockers, however, the Evidence here is much weaker.
Pathophysiological Mechanisms
The cough with ACE inhibitors is mainly attributed to an accumulation of Bradykinin and other peptides (e.g. substance P) back. ACE inhibitors not only inhibit the conversion of Angiotensin I to Angiotensin II, but also the degradation of Bradykinin. Increased bradykinin concentration in the tissues of the respiratory tract fibers to irritation of the sensory nerves and lead to a chronic, dry cough.
Other possible mechanisms include:
an increased production of prostaglandins and Leukotrienes;
a local inflammatory response in the respiratory tract;
a change in the sensitivity of the cough receptors.
Clinical Features
The typical ACE‑inhibitor‑associated cough has the following characteristics:
dry, non-productive cough;
Onset usually within the first weeks to months after initiation of therapy;
the lack of signs of a respiratory infection or other lung diseases;
Regression of the cough within 1-4 weeks after Discontinuation of the drug.
Diagnostics
The hand for a suspicious cough after taking a high blood pressure should include the following steps:
Medical history: Temporal relationship between drug intake and cough at the beginning, to the exclusion of other possible causes (e.g., Asthma, GERA Reflux, infections).
Physical examination and, if necessary, chest x‑ray, organic diseases of the lung to exclude.
A therapeutic trial discontinuation of the ACE Inhibitor for 2-4 weeks for the Review of an improvement.
If necessary: change to an AT1‑receptor blocker (so-called Sartans, such as Losartan, Valsartan), which do not cough.
Therapeutic Options
The cough should affect the patients ' quality of life significantly, has the following actions available:
The ACE Inhibitor and exchange discontinuation of other antihypertensive drug (for example, a Sartan, a calcium channel blocker or a beta-blocker).
In the case of persistent cough even after Discontinuation: further investigation to the exclusion of the diagnosis of other cough causes.
Supportive measures such as cough-relieving agent (with caution, since this does not relieve the respiratory tract) or local treatments in case of irritation of the mucous membranes.
Conclusion
Cough as a side effect of high blood pressure tablets, in particular, ACE inhibitors, is a well-known and pathophysiologically natural phenomenon. The early detection and, where appropriate, the exchange on alternative medicines allow for the effective treatment of arterial hypertension without affecting the quality of life of chronic cough. An individual risk‑Benefit assessment, and close patient education is of Central importance.
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