Cargando…

Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials

Background: Although angiotensin-converting enzyme (ACE) inhibitors are among the most-prescribed medications in the world, the extent to which they increase the risk of adverse effects remains uncertain. This study aimed to systematically determine the adverse effects of ACE inhibitors versus place...

Descripción completa

Detalles Bibliográficos
Autores principales: Na Takuathung, Mingkwan, Sakuludomkan, Wannachai, Khatsri, Rapheephorn, Dukaew, Nahathai, Kraivisitkul, Napatsorn, Ahmadmusa, Balqis, Mahakkanukrauh, Chollada, Wangthaweesap, Kachathip, Onin, Jirakit, Srichai, Salin, Buawangpong, Nida, Koonrungsesomboon, Nut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324875/
https://www.ncbi.nlm.nih.gov/pubmed/35886227
http://dx.doi.org/10.3390/ijerph19148373
_version_ 1784756909273776128
author Na Takuathung, Mingkwan
Sakuludomkan, Wannachai
Khatsri, Rapheephorn
Dukaew, Nahathai
Kraivisitkul, Napatsorn
Ahmadmusa, Balqis
Mahakkanukrauh, Chollada
Wangthaweesap, Kachathip
Onin, Jirakit
Srichai, Salin
Buawangpong, Nida
Koonrungsesomboon, Nut
author_facet Na Takuathung, Mingkwan
Sakuludomkan, Wannachai
Khatsri, Rapheephorn
Dukaew, Nahathai
Kraivisitkul, Napatsorn
Ahmadmusa, Balqis
Mahakkanukrauh, Chollada
Wangthaweesap, Kachathip
Onin, Jirakit
Srichai, Salin
Buawangpong, Nida
Koonrungsesomboon, Nut
author_sort Na Takuathung, Mingkwan
collection PubMed
description Background: Although angiotensin-converting enzyme (ACE) inhibitors are among the most-prescribed medications in the world, the extent to which they increase the risk of adverse effects remains uncertain. This study aimed to systematically determine the adverse effects of ACE inhibitors versus placebo across a wide range of therapeutic settings. Methods: Systematic searches were conducted on PubMed, Web of Science, and Cochrane Library databases. Randomized controlled trials (RCTs) comparing an ACE inhibitor to a placebo were retrieved. The relative risk (RR) and its 95% confidence interval (95% CI) were utilized as a summary effect measure. A random-effects model was used to calculate pooled-effect estimates. Results: A total of 378 RCTs fulfilled the eligibility criteria, with 257 RCTs included in the meta-analysis. Compared with a placebo, ACE inhibitors were associated with an significantly increased risk of dry cough (RR = 2.66, 95% CI = 2.20 to 3.20, p < 0.001), hypotension (RR = 1.98, 95% CI = 1.66 to 2.35, p < 0.001), dizziness (RR = 1.46, 95% CI = 1.26 to 1.70, p < 0.001), and hyperkalemia (RR = 1.24, 95% CI = 1.01 to 1.52, p = 0.037). The risk difference was quantified to be 0.037, 0.030, 0.017, and 0.009, respectively. Conclusions: We quantified the relative risk of numerous adverse events associated with the use of ACE inhibitors in a variety of demographics. This information can help healthcare providers be fully informed about any potential adverse consequences and make appropriate suggestions for their patients requiring ACE inhibitor therapy.
format Online
Article
Text
id pubmed-9324875
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93248752022-07-27 Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials Na Takuathung, Mingkwan Sakuludomkan, Wannachai Khatsri, Rapheephorn Dukaew, Nahathai Kraivisitkul, Napatsorn Ahmadmusa, Balqis Mahakkanukrauh, Chollada Wangthaweesap, Kachathip Onin, Jirakit Srichai, Salin Buawangpong, Nida Koonrungsesomboon, Nut Int J Environ Res Public Health Systematic Review Background: Although angiotensin-converting enzyme (ACE) inhibitors are among the most-prescribed medications in the world, the extent to which they increase the risk of adverse effects remains uncertain. This study aimed to systematically determine the adverse effects of ACE inhibitors versus placebo across a wide range of therapeutic settings. Methods: Systematic searches were conducted on PubMed, Web of Science, and Cochrane Library databases. Randomized controlled trials (RCTs) comparing an ACE inhibitor to a placebo were retrieved. The relative risk (RR) and its 95% confidence interval (95% CI) were utilized as a summary effect measure. A random-effects model was used to calculate pooled-effect estimates. Results: A total of 378 RCTs fulfilled the eligibility criteria, with 257 RCTs included in the meta-analysis. Compared with a placebo, ACE inhibitors were associated with an significantly increased risk of dry cough (RR = 2.66, 95% CI = 2.20 to 3.20, p < 0.001), hypotension (RR = 1.98, 95% CI = 1.66 to 2.35, p < 0.001), dizziness (RR = 1.46, 95% CI = 1.26 to 1.70, p < 0.001), and hyperkalemia (RR = 1.24, 95% CI = 1.01 to 1.52, p = 0.037). The risk difference was quantified to be 0.037, 0.030, 0.017, and 0.009, respectively. Conclusions: We quantified the relative risk of numerous adverse events associated with the use of ACE inhibitors in a variety of demographics. This information can help healthcare providers be fully informed about any potential adverse consequences and make appropriate suggestions for their patients requiring ACE inhibitor therapy. MDPI 2022-07-08 /pmc/articles/PMC9324875/ /pubmed/35886227 http://dx.doi.org/10.3390/ijerph19148373 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Na Takuathung, Mingkwan
Sakuludomkan, Wannachai
Khatsri, Rapheephorn
Dukaew, Nahathai
Kraivisitkul, Napatsorn
Ahmadmusa, Balqis
Mahakkanukrauh, Chollada
Wangthaweesap, Kachathip
Onin, Jirakit
Srichai, Salin
Buawangpong, Nida
Koonrungsesomboon, Nut
Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title_full Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title_fullStr Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title_full_unstemmed Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title_short Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials
title_sort adverse effects of angiotensin-converting enzyme inhibitors in humans: a systematic review and meta-analysis of 378 randomized controlled trials
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324875/
https://www.ncbi.nlm.nih.gov/pubmed/35886227
http://dx.doi.org/10.3390/ijerph19148373
work_keys_str_mv AT natakuathungmingkwan adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT sakuludomkanwannachai adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT khatsrirapheephorn adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT dukaewnahathai adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT kraivisitkulnapatsorn adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT ahmadmusabalqis adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT mahakkanukrauhchollada adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT wangthaweesapkachathip adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT oninjirakit adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT srichaisalin adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT buawangpongnida adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials
AT koonrungsesomboonnut adverseeffectsofangiotensinconvertingenzymeinhibitorsinhumansasystematicreviewandmetaanalysisof378randomizedcontrolledtrials