Quality of life and cough on antihypertensive treatment: a randomised trial of eprosartan, enalapril and placebo.
The objective of this study was to compare the quality of life and incidence of dry cough with the angiotensin II antagonist eprosartan, the ACE-inhibitor enalapril, and placebo, in hypertensive patients with a history of ACE-inhibitor cough. The study was a multicentre, randomised, double-blind, parallel group controlled trial. A total of 136 patients judged to have ACE-inhibitor cough during single-blind enalapril treatment which was lost during a subsequent placebo washout phase, were randomised to receive either eprosartan 300 mg twice daily, or enalapril 20 mg once daily, or placebo for 6 weeks. Self-completion questionnaires assessing quality of life and cough were examined at baseline and end of study. At study end point 23% of patients in the enalapril group and 5% in the eprosartan and placebo groups reported cough (which included definite, probable and possible coughs) (P = 0.02). After adjusting for multiple comparisons, the eprosartan group was not significantly different from either placebo or enalapril. There were no significant differences in the Psychological General Wellbeing Index (PGWB). In conclusion the incidence of self-reported cough on eprosartan was similar to that on placebo, and lower than on enalapril but this difference was not significant when adjustments were made for multiple comparisons. There were no differences in quality of life.
Rake
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Institute for Cancer Research, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London WC1E 7HT, UK.
Breeze
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Fletcher
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D000179:Acrylates / Q000008:administration & dosage* / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D003371:Cough / Q000139:chemically induced* / Q000453:epidemiology*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004656:Enalapril / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011336:Probability; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D013876:Thiophenes; D016896:Treatment Outcome
D000179:Acrylates; D000806:Angiotensin-Converting Enzyme Inhibitors; D007093:Imidazoles; D013876:Thiophenes; C068373:eprosartan; D004656:Enalapril