Tackling ACE inhibitor cough

814 Vol 350 • September 13, 1997 antagonism and cough induced by angiotensin converting enzyme inhibitor. Lancet 1997; 350: 15–18. 2 Robinson TD, Celermajer DS, Bye PTP. How to stop ACE inhibitor induced cough. Lancet 1997; 350: 3–4. 3 Pang L, Knox AJ. Bradykinin stimulated PGE2 release by human airway smooth muscle cells is associated with the induction of cyclooxygenase-2. Am J Respir Crit Care Med 1997; 155: A374. 4 Pang L, Knox AJ. Effect of interleukin 1β on tumour necrosis factor alpha and interferon gamma on the induction of cyclooxygenase-2 in cultured human airway smooth muscle cells. Br J Pharmacol 1997; 121: 579–87. 5 Meade EA, Smith WL, Dewitt DL. Differential inhibition of prostaglandin endoperoxide synthase (cyclooxygenase) isozymes by aspirin and other non-steroidal anti-inflammatory drugs. Eur J Biochem 1993; 268: 6610–14. a low-risk patient, one may question the use of any ACE inhibitor and try older, well-established, alternatives. If it emerges that all angiotensin antagonists do not reverse left-ventricular hypertrophy, the case for persisting with ACE inhibitors even with cough is very strong, and a novel strategy such as picotamide may be helpful.