Tolerability of angiotensin-receptor blockers in patients with intolerance to angiotensin-converting enzyme inhibitors: a systematic review and meta-analysis

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
Daniel CaldeiraCristina Sampaio

Abstract

Between 5% and 20% of patients treated with angiotensin-converting enzyme inhibitors (ACE inhibitors) develop intolerance. Angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]) can be used as an alternative treatment. In this study we aimed to evaluate the tolerability of ARBs in patients with intolerance to ACE inhibitors. The electronic databases PubMed, MEDLINE/EMBASE via Dialog, CENTRAL, and ISI Web of Knowledge were searched. Randomized controlled trials (RCTs) evaluating ARBs in patients with intolerance to ACE inhibitors were selected. Risk ratio (RR) and 95% confidence intervals (CIs) were estimated assuming the random effects method. We found 11 RCTs comparing ARBs with ACE inhibitors, diuretics, or placebo, and one RCT comparing high-dose versus low-dose ARB. ARBs had fewer cough events versus ACE inhibitors (RR 0.37; 95% CI 0.28, 0.48). ARBs had drug discontinuation (RR 0.99; 95% CI 0.84, 1.17) and cough risk (RR 1.01; 95% CI 0.74, 1.39) rates similar to placebo. Angioedema risk with ARBs was also similar to placebo (RR 1.62; 95% CI 0.17, 15.79). Compared with placebo, hypotension (RR 2.63; 95% CI 1.77, 3.92), renal dysfunction (RR 2.07; 95% CI 1.45, 2.95) and hyperkalemia (RR 3.37; 95% CI...Continue Reading

References

Feb 1, 1995·British Journal of Clinical Pharmacology·V CharlonK S Woo
Jul 1, 1996·Clinical Pharmacology and Therapeutics·N J BrownM R Griffin
Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Oct 24, 2002·Journal of the American College of Cardiology·Aldo P MaggioniUNKNOWN Val-HeFT Investigators (Valsartan Heart Failure Trial)
Aug 26, 2003·Congestive Heart Failure·Domenic A SicaClyde Yancy
Nov 12, 2003·The New England Journal of Medicine·Marc A PfefferUNKNOWN Valsartan in Acute Myocardial Infarction Trial Investigators
Jun 24, 2004·Journal of General Internal Medicine·Takeshi MorimotoDavid W Bates
Oct 16, 2004·Journal of Evaluation in Clinical Practice·Takeshi MorimotoDavid W Bates
Jan 19, 2005·Circulation·Duncan J CampbellMurray D Esler
Mar 9, 2005·American Journal of Hypertension·Hirofumi TomiyamaAkira Yamashina
Apr 6, 2006·Statistics in Medicine·Michael J BradburnA Russell Localio
Sep 28, 2006·Diabetes Care·Wolfgang C WinkelmayerBarry M Brenner
Apr 10, 2007·Lancet·Roland E SchmiederBernhard M W Schmidt
Jul 11, 2007·Allergy·M BasG Kojda
Apr 2, 2008·The New England Journal of Medicine·UNKNOWN ONTARGET InvestigatorsCraig Anderson
Aug 9, 2008·Journal of Clinical Epidemiology·Ralf BenderKristian Thorlund
Aug 12, 2008·Lancet·Syed Wamique Yusuf, Iyad N Daher
Jul 1, 1995·Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension·L E RamsayUNKNOWN Losartan Cough Study Group
Oct 10, 2008·The Cochrane Database of Systematic Reviews·Balraj S HeranJames M Wright
Dec 6, 2008·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Bret R HaymoreKent J DeZee
Mar 18, 2010·British Journal of Clinical Pharmacology·Murat BasGeorg Kojda
Nov 3, 2010·The American Journal of Medicine·Sripal BangaloreFranz H Messerli

❮ Previous
Next ❯

Citations

Mar 14, 2013·Expert Opinion on Pharmacotherapy·Henriette Farkas
Jan 13, 2015·Annals of Medicine·Maria PedrosaUNKNOWN Spanish Group for the Study of Bradykinin-Mediated Angioedema (SGBA) and the Spanish Committee of Cutaneous Allergy (CCA)
Aug 8, 2012·Annals of Epidemiology·Kenneth J MukamalShiva Gautam
Jun 8, 2013·Current Opinion in Allergy and Clinical Immunology·Paloma CampoCristobalina Mayorga
Aug 16, 2014·Journal of Pharmacy Practice·Stephanie E KnechtTracy E Macaulay
Sep 17, 2013·Journal of Cardiovascular Pharmacology and Therapeutics·Nicolás Roberto RoblesRoman Hernandez-Gallego
Apr 2, 2020·Physiological Research·J-S ShimA H Morice
Oct 8, 2015·Drugs & Aging·Thiruvinvamalai S Dharmarajan, Lekshmi Dharmarajan
Nov 14, 2014·American Journal of Hypertension·Islam Y ElgendyAnthony A Bavry
Nov 25, 2014·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Hazel Mae A AbrahamWilliam B White
Sep 12, 2019·The New England Journal of Medicine·Sandra C Christiansen, Bruce L Zuraw
Aug 18, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Fadia MayyasAnan Jarab
Oct 11, 2017·The Journal of Clinical Hypertension·Teresa BrownCatherine Monteleone
Mar 14, 2020·The Korean Journal of Internal Medicine·Hailian QuanHae-Young Lee
Jan 19, 2021·Expert Opinion on Drug Safety·Gonçalo Martins E PereiraDaniel Caldeira
Mar 3, 2020·Thérapie·Marion LepelleyLaurence Bouillet
Apr 14, 2021·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Mohammad Rafi KhezriMorteza Ghasemnejad-Berenji
Jul 2, 2021·The Annals of Pharmacotherapy·Melanie LamRicky Thumar

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Archives of Internal Medicine
E W van RijnsoeverJ Feenstra
JAMA : the Journal of the American Medical Association
Bruce M Psaty, Thomas Lumley
Circulation
WRITING GROUP MEMBERSAmerican Heart Association Statistics Committee and Stroke Statistics Subcommittee
© 2021 Meta ULC. All rights reserved