ACE inhibitors in hypertension: assessment of taste and smell function in clinical trials.
Taste and smell disturbances are infrequently reported adverse effects of treatment with captopril and are even less frequently reported with other ACE inhibitors. These adverse effects have been attributed to the chemical structure of the drugs used, although this relationship is the matter of some debate. A link between the taste disturbance associated with ACE inhibitors and changes in plasma zinc concentration has also been suggested, but again the evidence for this relationship is equivocal. One problem facing research in this area has been the lack of reliable assessment techniques for the quantitative evaluation of smell and taste function. Three quantitative methods for evaluating taste and smell function are described, together with the results of a pilot study aimed at evaluating the potential ease of application of these techniques in a larger group of patients. In this double-blind, crossover pilot study, 8-week treatment with lisinopril (20-40 mg once daily) was compared with captopril (25-50 mg twice daily) in 12 hypertensive patients. The two drugs produced similar falls in lying and standing blood pressure and neither drug produced a significant alteration in smell recognition, or olfactory or taste threshold. None of the minor changes observed appeared to correlate with either plasma zinc concentrations or intra-erythrocyte zinc levels. This study provides important observations on the use of these new techniques. Based on the wide variability of results obtained, the design of further clinical studies must address and overcome the many factors (age, sex, smoking, etc.) which may confound the study of drug effects on taste and smell.
Neil-Dwyer
G
G
Wessex Neurological Centre, Southampton, London, UK.
Marus
A
A
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D010865:Pilot Projects; D012684:Sensory Thresholds / Q000187:drug effects; D012903:Smell / Q000187:drug effects*; D013649:Taste / Q000187:drug effects*; D015032:Zinc / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D015032:Zinc