Which antihypertensive agent is contraindicated in pregnancy and may cause cough?

The chosen answer highlights ACE inhibitors as the antihypertensive agents contraindicated in pregnancy, which is accurate due to their potential to cause serious fetal harm, including risks of renal impairment, oligohydramnios, and skeletal abnormalities. ACE inhibitors work by inhibiting the angiotensin-converting enzyme, which leads to decreased production of angiotensin II, ultimately resulting in vasodilation and reduced blood pressure. However, their teratogenic effects during pregnancy are well documented, prompting guidelines to recommend alternatives for managing hypertension in pregnant individuals.

Additionally, ACE inhibitors are known to cause a persistent dry cough in some patients, attributed to the accumulation of bradykinin—a peptide that, when not broken down, can lead to this side effect. This characteristic further emphasizes the need for caution in prescribing these agents.

Other antihypertensive classes such as CCBs, ARBs, and thiazide diuretics possess different safety profiles in pregnancy. While ARBs also carry risks during pregnancy similar to ACE inhibitors and do not specifically mention cough as a common side effect, CCBs and thiazide diuretics are generally considered safer alternatives. Understanding these distinctions is crucial for appropriate patient management in both hypertension and pregnancy.