Abstract

Refractory Arterial Hypertension (RAH) is characterized by persistently high blood pressure values. Angiotensin Converting Enzyme (ACE) inhibitors in combination with other antihypertensive drugs are effective for RAH and have good clinical tolerance. According to the literature, the adverse effect of cough in patients using ACE inhibitors occurs in 5 to 20% of them. However, in clinical practice, the incidence appears to be higher, making it difficult the therapeutic adherence. This study aimed to evaluate the prevalence of cough induced by ACE inhibitors in patients with RAH as well as their clinical and laboratory characteristics. Cross-sectional study in a referral hospital in severe hypertensive cardiovascular disease. To assess the adverse effect cough in the use of ACE inhibitors, patients answered a questionnaire and blood pressure (BP) was measured on the day of the interview. 111 patients were analyzed and 67.6% were female (75). The average age was 62.8 ± 12 years. 100% (111) of the patients use or had used ACE inhibitors. The prevalence of cough was 64.9% (72). 62.2% (69) of patients were switched to angiotensin II receptor blocker as an ACE inhibitor substitute. 9.9% (11) of patients reported that the cough continued even after the discontinuation of ACE inhibitor. Patients used an average of 4.7 ± 1.1 antihypertensive medications. The average systolic blood pressure was 152.5 ± 28.4 mmHg and the average diastolic pressure was 88.5 ± 17.1 mmHg. We observed a high prevalence of cough associated with the use of ACE inhibitors in this population, different from that described in the literature. Despite the large number of antihypertensive drugs in use, the blood pressure was not controlled in most patients. It is possible that the non-use of ACE inhibitors may contribute to the low hypertensive control.

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