A 59-year-old man with hypertension and diabetic kidney disease is started on lisinopril 10 mg daily. One month later, his blood pressure is 128/82 mmHg (improved from 158/96), heart rate 72/min, and he reports a persistent dry cough without dyspnea. Serum creatinine is 1.8 mg/dL (baseline 1.6), and chest X-ray shows no infiltrates. He denies recent upper respiratory infection. Which of the following best explains this adverse effect?
- A)Excess aldosterone secretion
- B)Reflex sympathetic activation from venodilation
- C)Accumulation of bradykininGABARITO
- D)Inhibition of sodium chloride cotransport in the distal tubule
- E)Direct beta 1 receptor blockade
Explicação
ACE inhibitors decrease conversion of angiotensin I to angiotensin II and also decrease degradation of bradykinin. Increased bradykinin is responsible for the classic dry cough and can also contribute to angioedema. Ver explicação completa e trilha adaptativa →