Impact Factors Are Associated with Captopril-induced Cough:a Community-based Prospective Cohort Study
|Keywords||captopril-induced cough ADR BMI LVEF impact factors|
Background Angiotensin-converting enzyme inhibitors (ACEI) are routinely used for the treatment of hypertension and other diseases. However, reported adverse drug reactions (ADR), particularly dry cough, limited the use of it. Captopril took the lead in terms of ADR incidence. This study investigated the association between Captopril-induced cough and clinical impact factors. The purpose was to evaluate clinical factors predicting such cough in Chinese Han population.Methods3520community residents of Hong xinglong region of Heilongjiang Province participated in our survey from2009to2012. Patients who were taking catopril were studied, involving743people (male/female:284/469), aged33-89. We collected our data through questionnaires, physical examination and periodical follow-up.Results We found cough incidence of42%among the patients in the present study. Left ventricular ejection fraction (LVEF)<50%(odds ratio (OR)0.51,95%confidence interval (CI)0.31-0.84, P=0.008) and male (OR0.51,95%CI0.26-0.99, P=0.048) were protective factors, body mass index (BMI)(OR1.05,95%CI1.01-1.10, P=0.030) increased risk of captopril-induced cough. In addition, the proportion in female smoking group was lower than in non-smoking group,(OR:0.37,95%CI0.14-1.03, P<0.05), and in<60years old group was also significantly lower than in≥60years old group when patients were female and with renal insufficiency decompensation.(OR:0.12,95%CI0.01-0.96. P<O.05) Cough incidence of female who were using oral contraceptives (OC) was significantly lower than who weren’t, P<O.05. A binary multiple logistic regression model was used for the association between captopril-induced cough and clinical factors step by step. LVEF<50%(OR 0.51,95%CI0.31-0.84, P=0.008) and male (OR0.51,95%CI0.26-0.99, P=0.048) were protective factors, BMI (OR1.05,95%CI1.01-1.10, P=0.030) increased risk for adverse events.Conclusion21.1%Chinese Han people were using captopril. And42%among the patients in the present study occurred dry cough. From the results of the study, overweight patients, the woman and normal heart function in the Chinese Han population who use captopril are more likely to have the cough as well as non-smoking, non-OC and age≥60in female were the risk factors related captopril-induced cough.. Based on our observations of clinical factors and later genetics study, the discontinuation of ACEI therapy is the recommended approaches to prevent an ADR-cough.