the patient was diagnosed with essential hypertension

VQ, a 58-year-old African American male presented to his primary care physician (PCP) for routine follow-up. Eighteen months earlier, the patient was diagnosed with essential hypertension as indicated by a blood pressure reading of 155/98 mm Hg. At that time, the PCP prescribed the angiotensin-converting enzyme inhibitor (ACEI) lisinopril (20 mg/day) for blood pressure control. In the routine follow-up appointment, the patient’s blood pressure was 128/80 mm Hg. Upon questioning, however, he reported a troublesome chronic cough, which is a commonly known side effect of ACEIs. After eliminating allergies, infection, and cardiopulmonary conditions as underlying causes, the PCP attributed the cough to the ACEI and switched the patient’s antihypertensive medication to the angiotensin II receptor blocker (ARB) telmisartan (40 mg/day). In a 1-month follow-up appointment, the patient reported cessation of the cough, and his blood pressure was 126/78 mm Hg.

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