Iron supplementation inhibits cough associated with ACE inhibitors

Citation
Sc. Lee et al., Iron supplementation inhibits cough associated with ACE inhibitors, HYPERTENSIO, 38(2), 2001, pp. 166-170
Citations number
34
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
HYPERTENSION
ISSN journal
0194-911X → ACNP
Volume
38
Issue
2
Year of publication
2001
Pages
166 - 170
Database
ISI
SICI code
0194-911X(200108)38:2<166:ISICAW>2.0.ZU;2-C
Abstract
Dry cough is the most common limiting factor of ACE inhibitor (ACEI) use. G eneration of NO, a proinflammatory substance on bronchial epithelial cells, is increased by ACEI Using a randomized, double-blind, placebo-controlled trial, we tested the hypothesis that supplementing iron, an inhibitor of NO synthase, may reduce the cough associated with ACEI use. The subjects were 19 patients who had developed ACEI-induced cough. After a 2-week observati on period, they were randomized to a daily morning dose of either 256-mg fe rrous sulfate as a tablet or placebo for a treatment period of 4 weeks. The subjects were requested to rill out a cough diary by scoring the daily sev erity of the cough on a scale of 0 to 4. Mean daily cough scores for the la st week of the observation and treatment period were compared. Changes in b lood cell count and serum iron and ferritin concentration between the 2 per iods were evaluated. Mean daily cough scores during the observation and tre atment periods were 3.07 +/-0.70 and 1.69 +/-1.10, respectively, for the ir on group and 2.57 +/-0.80 and 2.35 +/-1.22, respectively, for the placebo g roup, showing a significant reduction in cough scores with iron supplementa tion (P<0.01) but not with placebo. Three subjects in the iron group showed almost complete cough abolition. No significant changes in laboratory data were observed in either group. In conclusion, iron supplementation success fully decreases ACEI-induced cough. This effect may be related to the decre ase of NO generation associated with the inhibition of NO synthase activity in bronchial epithelial cells.