ACE Inhibitor–Associated Cough in Children Common but Usually Well Tolerated compared to adults: Study

Dr. Shravani Dali

ACE Inhibitor–Associated Cough in Children Common but Usually Well Tolerated compared to adults: Study

Written By : Dr. Shravani Dali Published On 2026-02-19T21:00:43+05:30 | Updated On 19 Feb 2026 9:00 PM IST

Researchers have found in a new retrospective study that cough related to ACE inhibitor use in children may be more prevalent than previously recognized, but it is typically mild, well tolerated, and seldom requires changes in treatment or management.

ntroduction: ACE inhibitors are commonly prescribed in children. Anecdotally, captopril- induced cough is not thought to occur in children as frequently as in adults.

They performed a retrospective cohort study in 100 paediatric cardiology patients taking regular ACE inhibitors (ACE-I). Telephone interviews and questionnaires were used to ask patients and their families about their experience of ACE-I–related cough symptoms. Results: Of the 100 patients, 15% reported symptoms of captopril-related cough. Only 1% required a change in medication due to their cough. Captopril-related cough appears to be less significant in children than in adult populations. The reason for this is unclear, but it may be related to differences in ACE expression between adult and paediatric lungs.

The results suggest that cough associated with ACE-I use may be more prevalent in children than previously thought; however, it is generally well tolerated and rarely necessitates a change in management. Overall, these findings have practical implications for clinical decision-making in paediatric cardiology. While cough is a recognised adverse effect of ACE inhibitors, the low rate of treatment discontinuation in this cohort suggests that captopril remains a generally acceptable and manageable therapy for most children. Awareness of this potential side effect may help clinicians counsel families more effectively, distinguish medication-related cough from intercurrent respiratory illness, and avoid unnecessary medication changes. Further prospective studies with objective cough assessment and longer follow-up may help clarify the true incidence, underlying mechanisms, and age-related differences in ACE inhibitor–associated cough in paediatric populations.

Reference:

Coffey, M., McCrossan, B., Moore, R., & Shields, M. (2026). Captopril-induced cough: Does it matter in children? A retrospective cohort study. In Press. https://doi.org/10.2174/0115733963356686251201052241

Keywords:

ACE inhibitor–associated cough, pediatric hypertension, children, adults, angiotensin-converting enzyme inhibitors, ACE inhibitors, adverse drug reaction, cough incidence, tolerability, pediatric pharmacology, randomized controlled trials, ACE inhibitor vs ARB, bradykinin accumulation, drug safety in children, Cough, captopril, captopril cough, cardiology, pharmacology, pediatrics.

In PressACE inhibitor–associated coughchildrenadultsACE inhibitorscough incidencetolerabilitypediatric pharmacologyrandomized controlled trialsbradykinin accumulationCoughcaptoprilcardiologypharmacologypediatrics.

Source : In Press

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.