Angiotensin Receptor Blockers (ARBs) are medications primarily used to manage high blood pressure, heart failure, and certain kidney conditions. They help relax blood vessels, which lowers blood pressure and reduces strain on the heart. Many people taking these medications often wonder about potential side effects, with cough being a common concern.
Do ARBs Cause Cough?
While cough is a recognized side effect associated with certain blood pressure medications, it is generally uncommon with Angiotensin Receptor Blockers. The incidence of cough with ARBs is reported to be quite low, often similar to that observed with a placebo. Some studies indicate that a cough might occur in approximately 0% to 3% of individuals taking ARBs. This low rate makes ARBs a frequent alternative for patients who experience a cough from other blood pressure medications. If a cough does occur while on an ARB, it is typically mild and often resolves on its own.
ARBs Compared to ACE Inhibitors
How ACE Inhibitors Cause Cough
It is important to understand the difference between ARBs and Angiotensin-Converting Enzyme (ACE) inhibitors, as ACE inhibitors are well-known for causing a cough. These medications, such as lisinopril or enalapril, block the angiotensin-converting enzyme, which prevents the production of a hormone that narrows blood vessels. This enzyme also breaks down substances like bradykinin and substance P. When ACE is inhibited, bradykinin and substance P levels can increase in the airways, irritating sensory nerves and leading to a persistent, dry cough. The incidence of cough with ACE inhibitors can range widely, from about 4% to 35% of patients.
How ARBs Differ
In contrast, ARBs work by directly blocking the binding of angiotensin II to its receptors, rather than affecting the enzyme responsible for breaking down bradykinin. Since ARBs do not cause bradykinin accumulation, they have a significantly lower risk of inducing cough. This mechanistic difference explains why ARBs are often a preferred choice for individuals who cannot tolerate ACE inhibitors due to cough.
What to Do About a Cough
If you develop a cough while taking an Angiotensin Receptor Blocker, discuss it with your healthcare provider. While ARB-induced cough is rare, many other factors can cause a cough, such as allergies, infections, or other medications you might be taking. Your doctor can help determine the underlying cause of the cough and decide on the most appropriate course of action.
Never discontinue your medication without first consulting your doctor. Stopping blood pressure medication abruptly can be harmful and may worsen your underlying condition. Your healthcare provider may explore options such as monitoring the cough, ruling out other causes, or considering alternative treatments if the ARB is suspected. If an ARB is identified as the cause, your doctor can guide you on potential adjustments or alternative medications suitable for your health needs.