The ACE inhibitor is one of the most widely used drugs in cardiovascular medicine.It improves the survival rates and reducing complications in patients with cardiovascular conditions such as hypertension and heart failure.But however this drug produces dry cough as its most frequent side effect.
In most cases, patients with this troublesome complication discontinue the drug. Koreans have come out with a remedy for this complication.Iron supplementation may provide relief for patients suffering from angiotensin-converting enzyme (ACE) inhibitor-induced dry cough.
Kyung Pyo Hong, MD, of the Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, in his trial which included 19 subjects who had developed persistent dry cough while receiving ACE inhibitors for various heart conditions, found that the cough severity decreased following the supplementation with iron.
The subjects scored their symptoms on the basis of its severity which ranged from no cough (0) to severe cough that persisted and interfered with daily activities and sleep (4). Participants were then given either a daily morning tablet of 256 mg ferrous sulfate or placebo for 4 weeks, during which time monitoring of cough severity was continued. At the end of 4 weeks, iron levels in the blood were measured again.
It was found that supplementation of iron clearly showed a beneficial effect in most of these subjects.
The mechanism of ACE inhibitor-induced dry cough is unclear, but it is thought to be associated with the increase in nitric oxide (NO) generation caused by ACE inhibitors. NO is known to have inflammatory effects on bronchial epithelial cells.
Dr. Hong and colleagues embarked on their study based on reports that iron supplementation decreases NO generation or diminishes NO-related cell damage.