A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Choice A reason: ACE inhibitors cause dry cough by inhibiting bradykinin breakdown, which accumulates and irritates the airways. ARBs block angiotensin II receptors without affecting bradykinin, eliminating this side effect. This makes ARBs a suitable alternative for patients experiencing cough, confirming this as the correct choice. Choice B reason: Hyperkalemia occurs with both ACE inhibitors and ARBs due to reduced aldosterone production, which decreases potassium excretion. Both drug classes affect the renin-angiotensin-aldosterone system similarly, so switching to an ARB does not eliminate this risk, making this choice incorrect for the question. Choice C reason: Hypotension is a shared side effect of ACE inhibitors and ARBs, as both reduce blood pressure by inhibiting the renin-angiotensin system. ARBs block angiotensin II receptors, causing vasodilation similar to ACE inhibitors, so this side effect persists, making this choice incorrect. Choice D reason: Angioedema, though rare, can occur with both ACE inhibitors and ARBs. While less common with ARBs, it’s not eliminated, as it may result from mechanisms beyond bradykinin accumulation. Switching to an ARB doesn’t guarantee avoidance of angioedema, making this choice incorrect.