Question

I am male aged 46 years and hypertensive since 1989. I am being treated with more than several antihypertensive medications.

My doctor has now started me on Enalapril 10mg with Hydrochlorthiazide 25 in the noon. I am doing well and at times my BP in the late evening is 120-80. But my difficulty with Enalapril is a dry and persistent cough. Kindly suggest some alternative to ACE group.
 

Answer

We can appreciate your discomfort at having a continual cough. A cough can indeed be a side effect of Enalapril, but we would advise you to report this symptom to your own treating doctor, who knows you, your medical history and your present condition. There are many different antihypertensive medications, and it is often by "trial and error" that the most effective ones are found for each individual person. The many antihypertensive medications work in different ways. Some work by: 1. Decreasing the amount of fluid you have in your circulatory system. 2. Slowing the heart rate. 3. Dilating the arteries. 4. Blocking the production of enzymes that increase blood pressure. So you can see if your hypertension is caused by hardening of the arteries, giving you a diuretic (fluid pill) will not effect your pressure. It's up to your physician to define the cause of your high blood pressure and treat this cause. Your doctor would need to examine you and first establish whether it is the Enalapril, or some other condition causing your cough. If it is the drug, only your treating doctor can change it, and can observe you for relief of symptoms.
 

The combination of enalapril and hydrochlorothiazide is used to treat high blood pressure. Enalapril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly. Hydrochlorothiazide is in a class of medications called diuretics ( 'water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.
 

This other information may be of assistance to you in helping to keep your blood pressure under control: The main treatment for hypertension is antihypertensive medication prescribed by the doctor. To help "control" blood pressure, one should adhere to a healthydiet, free of saturated fats and cholesterol, and containing plenty of fibre (as found in fruits, vegetables and cereals). Also of importance is Regular physical exercise, losing extra weight, and Stress management, plus No smoking, and no more than 1-2 glasses red wine daily are best. Reducing sodium chloride (common salt) will also help reduce blood pressure. You will see a link below "How to start exercising" but all exercise is good as long as it is regular.
 

Related Links
Enalapril and Hydrochlorothiazide
Dietary Approaches to Stop Hypertension
Hypertension
How to start exercising
Stress Management