Angiotensin-Converting Enzyme Inhibitor Induced Cough in Chinese Patients: a Systematic Review and Meta-analysis

Area of Science:

• Pharmacology
• Clinical Medicine
• Epidemiology

Background:

• Angiotensin converting enzyme inhibitors (ACEIs) are widely prescribed for cardiovascular conditions.
• Cough is a known side effect of ACEI therapy, but its comparative risk in specific populations requires further investigation.

Purpose of the Study:

• To quantify the risk of ACEI-induced cough compared to non-ACEI-induced cough in Chinese patients.
• To assess the impact of ACEI-induced cough on treatment discontinuation rates.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials, case-control studies, and observational studies.
• Inclusion criteria focused on studies involving Chinese populations, ACEI use, non-ACEI control groups, and reported cough events.
• Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare cough incidence and withdrawal rates.

Main Results:

• Eleven studies with 1815 patients were included.
• The incidence of cough was 11% with ACEI treatment versus 2% with non-ACEI treatment (pooled RR: 5.16).
• Withdrawal rates due to cough were 4.13% for ACEI treatment versus 0.34% for non-ACEI treatment (pooled RR: 7.06).

Conclusions:

• The risk of ACEI-induced cough is approximately five times higher in Chinese patients compared to non-ACEI-induced cough.
• Treatment withdrawal due to cough is seven times more likely with ACEI therapy than with non-ACEI therapy in this population.