What symptom is often associated with a dry hacking cough in patients on ACE inhibitors?

A dry hacking cough is a well-known side effect of ACE inhibitors, and this is primarily due to increased bradykinin levels. ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, which leads to vasodilation and reduced blood pressure. However, another consequence of this inhibition is the accumulation of bradykinin, a peptide that can irritate the airway and cause a persistent cough. The cough is generally non-productive and can be quite bothersome for patients; understanding this relationship helps healthcare providers manage patient expectations and inform them about potential side effects when starting ACE inhibitor therapy.

The other answer choices do not specifically correlate with the symptom of a dry cough in the context of ACE inhibitor use. Fluid retention is typically associated with heart failure rather than directly with ACE inhibitors. Psychological stress and exposure to allergens, while related to various respiratory symptoms, do not have a direct link to the cough caused by bradykinin accumulation. Therefore, increased bradykinin levels is the most relevant and correct association in this scenario.