What should be considered when managing a patient experiencing dry cough due to ramipril within hypertension treatment?

Switching to an angiotensin receptor blocker (ARB) is a suitable approach for managing a patient experiencing a dry cough due to ramipril, which is an ACE inhibitor. ACE inhibitors, like ramipril, are known to cause a persistent dry cough in some patients due to the accumulation of bradykinin, which is not broken down when angiotensin-converting enzyme is inhibited.

ARBs do not have this same side effect mechanism since they block the angiotensin II receptor rather than inhibiting the enzyme that produces bradykinin. Therefore, transitioning to an ARB can effectively circumvent the cough while still providing the benefit of blood pressure control.

The first-line treatment status of ramipril highlights its overall effectiveness but does not address the adverse effect experienced by the patient. Simply continuing ramipril disregards the impact of the cough on quality of life and may lead to non-compliance.

Increasing the dose of ramipril would not resolve the cough issue, as it may worsen adverse effects without providing added therapeutic benefit in this context. Additionally, incorporating aliskiren, a direct renin inhibitor, carries its own risks, including a potential increase in adverse effects and is generally not the ideal strategy in the presence of