Effects of ACEI induced Cough on LV mass in Hypertensive patients and Its Reduction by Antihypertensive Medication

Abstract

Background and Objectives:Angiotensin-converting enzyme inhibitors have the effect of regression of left ventricular hypertrophy which has been known as the adverse prognostic factor in the cardiovascular diseases. There are some reports that patients having low ACE activity are prone to have the ACE inhibitorinduced cough. In this study we evaluate the difference of the regression of left ventricular mass according to ACE inhibitor induced cough. Materials and Methods:Newly detected hypertensive patients (N=108) from Jan. 1994 to Dec.1997 without cough and other contraindications to ACEI were prospectively prescribed ACEI and followed up for two years whether they have experienced ACE inhibitor induced cough or not. Cough and non-cough group are analyzed the amount of regression of left ventricular mass by ECG. Results:Left ventricular mass index decreases significantly from 128±38 to 119±36 g/m (ΔLVMI=-9±22 g/m, p<0.05), after ACE inhibitors had been used for two years. There is no difference between cough and non-cough group. When subgroup analysis has been done according to sex and the presence of the baseline left ventricular hypertrophy, LVH (+) group and female have the tendency of the larger amount of decreasing of LVMI than LVH (-) group and male respectively [LVH (+):LVH (-)=-15±26:-3±15, M:F=-12±24:-7± 19]. After the adjusting of the influence of baseline LVM and sex, the amount of degree of LVMI regresssion in case of the men without baseline LVH is significantly different in cough and non-cough group. LVMI decreases significantly in non-cough group, but not in cough group. Conclusion:ACE inhibitors have the effect of the regression of LVMI by ECG. The amount of change of LVMI is greater in female and the patients with baseline LVH. In case of men without LVH, non-cough group has larger amount of decreasing of LVMI than cough group. (Korean Circulation J 2000;30(12):1546-1554)