Candesartan cilexetil is not associated with cough in hypertensive patients with enalapril-induced cough

The aim of this study was to evaluate the occurrence of dry cough during tr eatment with candesartan cilexetil, enalapril, or placebo in patients with hypertension and a history of angiotensin converting enzyme (ACE)-inhibitor -related cough. Patients with confirmed cough during an enalapril (10 mg) c hallenge period, followed by no cough during a placebo dechallenge period w ere randomized to 8 weeks of double-blind treatment with candesartan cilexe til (8 mg) (n = 62), enalapril (10 mg) (n = 66), or placebo (n = 26). Incid ence and severity of dry cough was evaluated by the symptom assessment ques tionnaire, frequency of dry cough by a visual analog scale, and the possibl e impact on quality of life by the minor symptom evaluation (MSE) profile. The percentage of patients with cough was significantly lower with candesar tan cilexetil (35.5%) than with enalapril (68.2%, P < .001), and did not di ffer between candesartan cilexetil and placebo (26.9%, P > .20). Patients c oughed less frequently and with less severe cough with candesartan cilexeti l than with enalapril, and similarly with candesartan cilexetil and placebo . Changes in the MSE profile were minor, although candesartan cilexetil had better scores for contentment than placebo (P = .03), and also tended to b e associated with better sleep than enalapril (P = .08). In hypertensive pa tients with ACE-inhibitor-induced cough, the incidence, frequency, and seve rity of dry cough was significantly lower with candesartan cilexetil than w ith enalapril, and no different from that found with placebo. (C) 2000 Amer ican Journal of Hypertension, Ltd.