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January 20, 1989, Vol 261, No. 3 >
ARTICLE | January 20, 1989

Pulmonary Function and Airway Responsiveness During Long-term Therapy With Captopril FREE

Louis-Philippe Boulet, MD; Joanne Milot, BSc; Noël Lampron, MD; Yves Lacourcière, MD
[+] Author Affiliations

Reprint requests to Centre de Pneumologie, Hôpital Laval, 2725 Chemin Sainte-Foy, Sainte-Foy, Quebec, Canada G1V 4G5 (Dr Boulet).


JAMA. 1989;261(3):413-416. doi:10.1001/jama.1989.03420030087036
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References

Angiotensin-converting enzyme inhibitors sometimes cause cough; the mechanism is unknown. We therefore studied the effects of ambulatory treatment with captopril on pulmonary function and on nonspecific bronchial responsiveness to methacholine in 15 hypertensive subjects. Lung volumes, expiratory flows and nonspecific bronchial responsiveness to methacholine using doses up to 64 g/L were measured before and four and eight weeks after captopril treatment was started. Throughout the study the subjects recorded respiratory symptoms and peak expiratory flow rates. In four subjects a persistent cough developed related to the use of captopril, but this was not associated with the development of airflow obstruction or bronchial hyperresponsiveness. The mean provocative concentration of methacholine that resulted in a 20% fall in the forced expiratory volume in 1 s was 43.6 ± 1.8 g/L after eight weeks of captopril treatment compared with 61.6 ± 1.2 g/L at the baseline evaluation. We concluded that there was no significant change in lung function during treatment with captopril. The development of a cough related to this medication is not associated with the development of airflow obstruction or airway hyperresponsiveness.

(JAMA 1989;261:413-416)

REFERENCES

1 +
Brunner HR, Nussberger J, Waeber B:  The present molecules of converting inhibitors . J Cardiovasc Pharmacol 1985;;7( (suppl 1) ):2-11.
2 +
Di Bianco R:  Adverse reactions with angiotension converting enzyme (ACE) inhibitors . Med Toxicol Adverse Drug Exp 1986;;1:122-141.
3 +
McNeil JJ, Anderson A, Christophidis N, et al:  Taste loss associated with oral captopril treatment . Br Med J 1979;;15:1555-1556.
4 +
Mason JC, Phil D, Hilton PJ:  Reversible renal failure due to captopril in a patient with transplant artery stenosis: Case report . Hypertension 1983;;5: 623-627.
5 +
Mitchell A, Gillies A, Carney S, et al:  Cough and captopril . Arch Intern Med 1986;;146:1017.
6 +
Smith WM, Kulaga SF, Moncloa F, et al:  Overall tolerance and safety of enalapril . J Hypertens 1984;;2:113-117.
7 +
Ostermann G,Freneaux E, Germain ML, et al:  Toux induite par les inhibiteurs de l'enzyme de conversion . Therapie 1986;;41:404-405.
8 +
Semple PF, Herd GW:  Cough and wheeze caused by inhibitors of angiotensin-converting enzyme . N Engl J Med 1986;;314:61.
9 +
Sesoko S, Kaneko Y:  Cough associated with the use of captopril . Arch Intern Med 1985;;145:1524.
10 +
Carruthers SG:  Severe coughing during captopril and enalapril therapy . Can Med Assoc J 1986;;135:217-218.
11 +
Hood S, Nicholls MG, Gilchrist NL:  Cough with angiotensin converting-enzyme inhibitors . NZ Med J 1987;;100:6-7.
12 +
Ollivier JP, Ducrocq MB, Droniou J:  Un effet secondaire des inhibiteurs de l'enzyme de conversion: La toux . Presse Med 1987;;16:759-761.
13 +
Stark RD:  Mechanism of cough with angiotensin-converting enzyme inhibition . Arch Intern Med 1986;;146:1227.
14 +
Salena BJ:  Chronic cough and the use of captopril: Unmasking asthma . Arch Intern Med 1986;; 146:202-203.
15 +
Corrao WM, Braman SS, Irwin RS:  Chronic cough as the sole presenting manifestation of bronchial asthma . N Engl J Med 1979;;300:636-637.
16 +
Bucknall CE, Neilly JB, Carter R, et al:  Bronchial hyperreactivity in patients who cough after receiving angiotensin converting enzyme inhibitors . Br Med J 1988;;296:86-88.
17 +
Sala H, Abad J, Juanmiquel LI, et al:  Captopril and bronchial reactivity . Postgrad Med J 1986;; 62:76-77.
18 +
DuBois AB, Botelho SY, Bedell GN, et al:  A rapid plethysmographic method for measuring thoracic gas volume: A comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects . J Clin Invest 1956;; 35:322-326.
19 +
Cockcroft DW, Killian DN, Mellon JJA, et al:  Bronchial reactivity to inhaled histamine: A method and clinical survey . Clin Allergy 1977;;7:235-243.
20 +
Dehaut P, Rachille A, Martin RR, et al:  Histamine dose-response curves in asthma: Reproductibility and sensitivity of different indices to assess response . Thorax 1983;;38:516-522.
21 +
Cockcroft DW:  Bronchial inhalation tests: I. Measurement of nonallergic bronchial responsiveness . Ann Allergy 1985;;55:527-537.
22 +
Popa V:  Captopril-related (and induced?) asthma . Am Rev Respir Dis 1987;;136:999-1000.
23 +
Nicholls MG, Gilchrist NL:  Sulindac and cough induced by converting enzyme inhibitors . Lancet 1987;;1:872.

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1 +
Brunner HR, Nussberger J, Waeber B:  The present molecules of converting inhibitors . J Cardiovasc Pharmacol 1985;;7( (suppl 1) ):2-11.
2 +
Di Bianco R:  Adverse reactions with angiotension converting enzyme (ACE) inhibitors . Med Toxicol Adverse Drug Exp 1986;;1:122-141.
3 +
McNeil JJ, Anderson A, Christophidis N, et al:  Taste loss associated with oral captopril treatment . Br Med J 1979;;15:1555-1556.
4 +
Mason JC, Phil D, Hilton PJ:  Reversible renal failure due to captopril in a patient with transplant artery stenosis: Case report . Hypertension 1983;;5: 623-627.
5 +
Mitchell A, Gillies A, Carney S, et al:  Cough and captopril . Arch Intern Med 1986;;146:1017.
6 +
Smith WM, Kulaga SF, Moncloa F, et al:  Overall tolerance and safety of enalapril . J Hypertens 1984;;2:113-117.
7 +
Ostermann G,Freneaux E, Germain ML, et al:  Toux induite par les inhibiteurs de l'enzyme de conversion . Therapie 1986;;41:404-405.
8 +
Semple PF, Herd GW:  Cough and wheeze caused by inhibitors of angiotensin-converting enzyme . N Engl J Med 1986;;314:61.
9 +
Sesoko S, Kaneko Y:  Cough associated with the use of captopril . Arch Intern Med 1985;;145:1524.
10 +
Carruthers SG:  Severe coughing during captopril and enalapril therapy . Can Med Assoc J 1986;;135:217-218.
11 +
Hood S, Nicholls MG, Gilchrist NL:  Cough with angiotensin converting-enzyme inhibitors . NZ Med J 1987;;100:6-7.
12 +
Ollivier JP, Ducrocq MB, Droniou J:  Un effet secondaire des inhibiteurs de l'enzyme de conversion: La toux . Presse Med 1987;;16:759-761.
13 +
Stark RD:  Mechanism of cough with angiotensin-converting enzyme inhibition . Arch Intern Med 1986;;146:1227.
14 +
Salena BJ:  Chronic cough and the use of captopril: Unmasking asthma . Arch Intern Med 1986;; 146:202-203.
15 +
Corrao WM, Braman SS, Irwin RS:  Chronic cough as the sole presenting manifestation of bronchial asthma . N Engl J Med 1979;;300:636-637.
16 +
Bucknall CE, Neilly JB, Carter R, et al:  Bronchial hyperreactivity in patients who cough after receiving angiotensin converting enzyme inhibitors . Br Med J 1988;;296:86-88.
17 +
Sala H, Abad J, Juanmiquel LI, et al:  Captopril and bronchial reactivity . Postgrad Med J 1986;; 62:76-77.
18 +
DuBois AB, Botelho SY, Bedell GN, et al:  A rapid plethysmographic method for measuring thoracic gas volume: A comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects . J Clin Invest 1956;; 35:322-326.
19 +
Cockcroft DW, Killian DN, Mellon JJA, et al:  Bronchial reactivity to inhaled histamine: A method and clinical survey . Clin Allergy 1977;;7:235-243.
20 +
Dehaut P, Rachille A, Martin RR, et al:  Histamine dose-response curves in asthma: Reproductibility and sensitivity of different indices to assess response . Thorax 1983;;38:516-522.
21 +
Cockcroft DW:  Bronchial inhalation tests: I. Measurement of nonallergic bronchial responsiveness . Ann Allergy 1985;;55:527-537.
22 +
Popa V:  Captopril-related (and induced?) asthma . Am Rev Respir Dis 1987;;136:999-1000.
23 +
Nicholls MG, Gilchrist NL:  Sulindac and cough induced by converting enzyme inhibitors . Lancet 1987;;1:872.

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