Prevalence and Risk Factors for Angiotensin Converting Enzyme Inhibitor Induced Cough among Diabetic Patients in a Tertiary Institution in Southeast Nigeria

Abstract

Introduction: The prevalence of diabetes mellitus (DM) is increasing worldwide, with the attendant cardiovascular morbidity and mortality especially heightened by co-existing hypertension and proteinuria. The renin–angiotensin system (RAS) has been a drug target of particular interest because of its involvement in the cardiovascular and renal disease progression. The ACE inhibitors (ACEI) have been proven effective for reducing cardiovascular events and mortality in patients with cardiovascular disease. However, these medications are associated with cough in certain subjects which could lead to poor drug adherence and increased cardiovascular morbidity and mortality. This study sought to determine the prevalence of ACEI-induced subjects in DM patients. Methodology: A total of 100 patients who fit eligibility criteria were included in the study. A questionnaire was administered on subjects who were on ACEI while data was abstracted from the medical records of subjects who had been on the medication in the preceding two years. Results: The prevalence of ACEI-induced cough was 20%. Female gender (p=0.022) and prolonged use of the medication (p=0.017) positively correlated with cough among DM subjects who had received ACEI in the preceding 2 years, or were on the medication at the time of this study. There was no correlation between the type of ACEI, anthropometry, and glycaemic control and the prevalence of cough among the subjects.       Conclusion: Our study suggests that the prevalence of cough among patients with diabetes mellitus who have been exposed to ACEI is substantial. Keywords: ACE inhibitors; cough; diabetes mellitus.