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A hypertensive diabetic starts lisinopril; months later a dry cough begins. This is the ACE inhibitor cough — bradykinin accumulation irritating airways (not dangerous, but maddening); switching to an ARB (losartan — same angiotensin blockade, no bradykinin) keeps the kidney protection diabetics need. ACE inhibitors/ARBs are first-line in diabetes/CKD (they slow proteinuria), but both are teratogenic — stop in pregnancy. The cough is the clue — same benefit, different molecule.