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ACE inhibitor cough — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareACE inhibitor coughUSMLE Step 3

A 66-year-old man develops cough 3 weeks after starting lisinopril. He has no fever, dyspnea, wheezing, or abnormal chest findings. Chest radiograph is normal. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: D — Accumulation of bradykinin and substance P

ACE inhibitor cough is thought to result from accumulation of bradykinin and substance P in the respiratory tract.

Reference: ACC/AHA hypertension pharmacology; USMLE Step 3 Content Outline