Which side effect is most characteristic of ACE inhibitors and not typically seen with ARBs?

Which side effect is most characteristic of ACE inhibitors and not typically seen with ARBs?

• A. Cough
• B. Hyperkalemia
• C. Angioedema
• D. Dizziness

Answer: (A)

ACE inhibitors can cause a dry, persistent cough because they raise bradykinin levels by inhibiting its breakdown. ARBs don’t affect bradykinin, so this cough is uncommon with them. Other side effects like hyperkalemia and dizziness can occur with both classes, and angioedema is more closely linked to ACE inhibitors due to bradykinin, though it can happen with ARBs too though less frequently. The cough, by contrast, is the classic distinguishing feature and is the best clue that you might be dealing with an ACE inhibitor rather than an ARB. If this cough develops, switching to an ARB is a common management approach.

ACE inhibitors can cause a dry, persistent cough because they raise bradykinin levels by inhibiting its breakdown. ARBs don’t affect bradykinin, so this cough is uncommon with them. Other side effects like hyperkalemia and dizziness can occur with both classes, and angioedema is more closely linked to ACE inhibitors due to bradykinin, though it can happen with ARBs too though less frequently. The cough, by contrast, is the classic distinguishing feature and is the best clue that you might be dealing with an ACE inhibitor rather than an ARB. If this cough develops, switching to an ARB is a common management approach.