Which finding in a patient taking an ACE inhibitor during a home visit would prompt you to contact the provider about changing therapy?

• A. Frequent urination
• B. Blood pressure 138/86
• C. Persistent cough
• D. Dizziness sometimes

Answer: (C)

ACE inhibitors can trigger a persistent cough for many patients due to bradykinin buildup. This cough is an intolerance/side effect rather than a sign of effective blood pressure control, and it can be bothersome enough to affect adherence. If a patient on an ACE inhibitor reports a chronic cough during a home visit, contacting the provider to discuss switching to a different class (often an ARB) is the appropriate step to relieve symptoms while maintaining BP management.

In contrast, a blood pressure reading like 138/86 is generally acceptable for many adults and doesn’t by itself require changing therapy. Dizziness can occur with some regimens but isn’t as specific or disruptive as a persistent cough. Frequent urination is not a typical adverse effect of ACE inhibitors alone and wouldn’t alone prompt a change in therapy based on this drug class.