benazepril and Cough

Stage 3 is the key phase of chronic kidney disease. Traditional Chinese medicine (TCM) has been used for the treatment of chronic kidney disease. But a large sample trial is desirable.. A total of 578 Chinese patients with primary glomerulonephritis in CKD stage 3 were randomly assigned to three groups: patients received TCM (TCM group), benazepril (Ben group), TCM combined with benazepril (TCM+Ben group). Patients were followed up for 24 weeks. The primary endpoint was the time to the composite of 50% increased of serum creatinine, end stage renal disease or death.. eGFR in the TCM and the TCM+Ben group were improved (week 24 vs. baseline, P<0.05) while eGFR in the Ben group was decreased (week 24 vs. baseline, P>0.05). 24h urinary protein excretion (UP) and urinary albumin/creatinine (UAlb/Cr) were decreased in the TCM+Ben (week 24 vs. baseline, P<0.05) and the Ben group (week 24 vs. baseline, P>0.05). UP and UAlb/Cr were increased in the TCM group to week 12, then were stable (week 24 vs. baseline, P<0.05). The hemoglobin in the TCM group was also improved (week 24 vs. baseline, P<0.05). The accumulative survival rate in the TCM+Ben group was higher than that in the TCM group and the Ben group (P=0.044). Side effects in the TCM group were the lowest in these groups (P<0.05). The patients with dry cough in the TCM+Ben group and the Ben group were increased as compared with the TCM group (P<0.05). Hyperkalemia happened less frequently in the TCM group as compared with the other two groups (P=0.052).. For the patients with CKD stage 3, TCM can improve eGFR and hemoglobin with lower side effects. Benazepril significantly decreased the proteinuria. Chinese medicine integrated with benazepril can ameliorate renal function and decrease proteinuria synergistically.

Topics: Adult; Albuminuria; Benzazepines; Cough; Creatinine; Double-Blind Method; Drug Therapy, Combination; Drugs, Chinese Herbal; Female; Glomerular Filtration Rate; Glomerulonephritis; Hemoglobins; Humans; Hyperkalemia; Kidney; Kidney Failure, Chronic; Male; Medicine, Chinese Traditional; Middle Aged; Phytotherapy; Proteinuria; Severity of Illness Index

To evaluate the efficacy and safety of Benazepril used among the essential hypertensives.. 1 831 essential hypertensive patients aged 35 to 75 were randomly selected from a community and followed for 18 months. The level of blood pressure, status of taking Benazepril and side effects were sequencially collected.. 1/3 of the patients had taken antihypertensive drug before the study and the rate of compliance was over 96%. The effective rate of Benazepril was 73.6% at three months and increased to 84.7% at 18 months. Comparing with the baseline data, SBP and DBP declined 10.8 mmHg and 6.7 mmHg respectively. The rate of side effect was 22.7%. Cough was most commonly seen among side effects. The peak of first recording on side effect occurred at three months including 60% of them mild.. Results showed that Benazepril had good efficacy and safety for the essential hypertension patients in a long-term observation.

Topics: Adult; Aged; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Benzazepines; China; Cough; Female; Follow-Up Studies; Humans; Hypertension; Male; Middle Aged; Product Surveillance, Postmarketing

Cough and angioedema are well-known adverse reactions of ACE inhibitors. However, other adverse effects of upper airways such as postnasal drainage, rhinitis and nasal blockage, are less frequently recognised. These might share the same pathophysiological mechanism: bradykinin accumulation. We present two patients with ACE inhibitor-induced upper respiratory symptoms that improved after the discontinuation of ACE-inhibitors and substitution with angiotensin II receptor blockers. The incidence of these adverse events is not accurately known, since these are not required to be reported, but it is estimated to be low. This presents challenges to the physician and demonstrates the importance of keeping it as a differential diagnosis. Most physicians are aware of ACE inhibitor-induced cough but not of ACE inhibitor-induced nasal blockage, rhinitis or postnasal drainage. Identifying these can avoid unnecessary diagnostic tests and inappropriate treatment.

Topics: Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Cough; Humans; Male; Nasal Obstruction; Nose; Rhinitis

To investigate the long-term effect, safety and tolerability of benazepril in general hypertensive patients.. We conducted a three-year community-based postmarketing surveillance on benazepril among 1831 essential hypertensive patients (age range from 35 to 88 years) in Shanghai.. 74.3% of patients persisted in medication taking and were with optimal compliance in a 3-year-follow-up program. Among those taking medication as prescribed after 3 years, 75.7% of them attained systolic blood pressure (SBP) target level of 140 mm Hg (1 mm Hg = 0.133 kPa), 87.4% attained diastolic blood pressure (DBP) target level of 90 mm Hg, and 71.5% attained total target level of 140/90 mm Hg. The reductions were approaching 15 mm Hg for SBP, 10 mm Hg for DBP, and 5 mm Hg for pulse pressure (PP) during the 3 year period. No serious adverse drug reactions (ADRs) were detected during the 3 years follow-up. Cough was the most common ADR. The cumulative incidence of benazepril related cough was 23.6% in women, significant higher than in men (18.8%).. Benazepril was safe and tolerable when applied in hypertensive patients.

Topics: Adult; Aged; Aged, 80 and over; Antihypertensive Agents; Benzazepines; China; Cough; Female; Humans; Hypertension; Male; Middle Aged; Product Surveillance, Postmarketing

To investigate the risk factors of benazepril related cough.. Case-control study nested in a community-based postmarketing surveillance was carried out. One thousand eight hundred and thirty-one hypertensive patients screened from a Chinese community were recruited to take benazepril for 3 years. Demographic characteristics and behavior risks were investigated and the level of uric acid and creatinine were tested at baseline. Episodes of benazepril related cough during follow period were recorded.. Within half a year of administration, the incidence rates of cough were as high as 18.35% in women and 12.11% in men. Incidence decreased significantly when time went by. Two years later of administration, first occurrences of cough were still seen. Based on logistic regression analysis, women were more likely to develop cough (OR = 2.193, 95% CI: 1.500 - 3.206). The association between decompensated kidney function and cough occurrence was only detected in women (OR = 3.432, 95% CI: 1.954 - 6.028). Women aged 65 or more had 1.672 (95% CI: 1.040 - 2.688) times risk than women aged 35 to 64 years. In men, the OR of developing cough was 1.689 (95% CI: 0.976 - 2.924) for daily drinking alcohol less than 100 g but increased to 2.478 (95% CI: 1.148 - 5.347) when drinking 100 g or more, but not the determinant ones.. Women, older age, drinking alcohol and decompensated kidney function were the possible risk factors for benazepril related cough, but not the determinant ones.

Topics: Adult; Age Factors; Aged; Alcohol Drinking; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Case-Control Studies; China; Cough; Female; Follow-Up Studies; Humans; Hypertension; Incidence; Kidney Function Tests; Logistic Models; Male; Middle Aged; Product Surveillance, Postmarketing; Risk Factors; Sex Factors

To investigate the associations between angiotensin converting enzyme inhibitors (ACEIs) related cough and ACE I/D and bradykinin beta(2) receptor (BDKRB2) C/T polymorphism.. A case-control study, nested in a 3-year community-based postmarketing surveillance of benazepril in 1 831 Chinese hypertensives was carried out. Three hundred and fifty-one cases having suffered benazepril related cough were identified and genotyped. Genotyped controls were selected through a stratified sampling design by age, sex and kidney function status.. The allele frequencies in cases were I 65.4%, D 34.6% and T 53.0%, C 47.0% and the genotype frequencies were II 42.2%, ID 46.4%, DD 11.4% (ACE) and CC 21.6%, CT 50.9%, TT 27.6% (BDKRB2), respectively. Genotype frequencies were both in Hardy-Weinberg equilibrium. According to stratified analyses by sex, kidney function status and age, no association was found between BDKRB2 C/T polymorphism and cough. For ACE I/D polymorphism, in men with decompensated kidney function, patients with ID or DD genotype having 4.805 times the risk of those with II genotype in developing cough. In women aged 35 to 49 years with normal or compensated kidney function, the OR of DD genotype was 5.128. No associations were detected in other subgroups.. It was suggested that kidney function status and some specific characteristics surrogated by age and sex had modified the effect of ACE I/D variant on cough.

Topics: Adult; Aged; Angiotensin-Converting Enzyme Inhibitors; Benzazepines; Cough; Female; Humans; Hypertension; Male; Middle Aged; Peptidyl-Dipeptidase A