One of the telltale adverse effects of ACE inhibitors, including lisinopril, is a chronic, hacking cough --- a potential side effect that patients often don't hear about. Studies suggest that up to a third of all patients taking an ACE inhibitor will develop this type of chronic dry cough, and the cough often doesn't go away when they stop taking the drug. This happens more with women than with men, and more with African Americans and Asians than others.
You might be wondering how a blood pressure drug could cause respiratory problems. ACE inhibitors affect the process of renal perfusion, which is how the kidneys filter impurities out of the blood. As an older person loses kidney function, the change is reflected in his or her glomerular filtration rate (GFR). The lower your GFR, the more difficult it is for your body to clear drugs from your kidneys and bloodstream, lowering their effectiveness and potentially causing them to accumulate at toxic levels in the body. In this case, the insoluble by-products of the drugs, called kinins, are not filtered out of the blood. They then flow out of the kidneys and lodge themselves in the lungs' bronchial tubes. The coughing spells represent the body's attempt to expel the kinins from the lungs. Even after the drug is stopped, the cough can linger for months until all the kinins eventually find their way out of the lungs.
Prescribing physicians and patients NEED to be aware of the side effects of these blood pressure medications. Many of the patients we see with this problem are being treated for sinusitis, bronchitis, sore throat, laryngitis, asthma and many other respiratory conditions that are all a result of the ACE-inhibitor therapy. Respiratory conditions are getting harder and harder to get over year after year lately due to many factors. I've had a handful of patients treated with steroids and antibiotics this last year when the cough that was being treated was a direct side effect of Lisinopril. Keeping your Vitamin D levels at optimum ranges is just that more important. Vitamin D has shown to decrease the cases of respiratory conditions, seasonal flu, and helps regulate blood pressure in some individuals. And people who deal with Seasonal Affective Disorder (SAD) have shown to benefit from Vitamin D use during the winter as it is a precursor to Serotonin for your brain. Do you know your Vitamin D range?
Dr. J