What question did this study set out to answer?

To determine the incidence and clinical characteristics of ACE inhibitor-induced cough and angioedema in an indigenous Nigerian population treated with low-dose regimens.

July 1, 2000British Journal of Clinical PharmacologyOpen Access

Angioedema and cough in Nigerian patients receiving ACE inhibitors

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Why the study?

Does the use of low-dose ACE inhibitors in Nigerian patients result in a lower incidence of angioedema compared to reported rates in African-Americans?

Population

369 Nigerian in-patients and ambulatory patients receiving ACE inhibitors for cardiovascular and renal…

Design

Cohort

Follow-up

1200 patient-years (10-year review)

Authors

AAA.A. AjayiMorehouse School of Medicine AAA. Q. AdigunUniversity College Hospital, Ibadan

Discussion

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Implication

Low-dose ACEIs linked to lower angioedema rates in Nigerians than prior African-American estimates; hypothesis-generating and requires prospective confirmation before practice change.

Key Points

To determine the incidence and clinical characteristics of ACE inhibitor-induced cough and angioedema in an indigenous Nigerian population treated with low-dose regimens.
Monitored adverse drug reactions at a university teaching hospital in Nigeria across a prospective cohort (N=100) receiving captopril or enalapril and a 10-year retrospective cohort (N=369; 1,200 patient-years) receiving captopril (12.5–50 mg), enalapril (2.5–10 mg), or lisinopril (2.5–5 mg).
In the prospective cohort, cough incidence was 27% with a significant 3:1 female preponderance (48% in females vs 16% in males, P < 0.001) and a 4% drug withdrawal rate due to severe coughing in postmenopausal women.
In the 10-year cohort, 2 cases of nonfatal angioedema occurred (0.54% incidence; 1.6 per 1,000 patient-years), lower than the expected rate of 5–7 cases per 1,000 patient-years reported in Western African-descendant populations.

Structured PICO

Does the use of low-dose ACE inhibitors in Nigerian patients result in a lower incidence of angioedema compared to reported rates in African-Americans?

Population

369 Nigerian in-patients and ambulatory patients receiving ACE inhibitors for cardiovascular and renal diseases

Intervention

Low doses of ACE inhibitors (captopril 12.5-50 mg, enalapril 2.5-10 mg, lisinopril 2.5-5 mg)

Outcome

Incidence of ACE inhibitor-induced cough and angioedemasafety

The use of low-dose ACE inhibitors in Nigerian patients is associated with a high incidence of cough but a lower-than-expected incidence of angioedema compared to African-American cohorts.

Limitations

Low doses of ACE inhibitors were used, making it unclear if standard doses would result in a higher incidence of angioedema

Cite This Study

Ajayi et al. (2000) studied this question.

synapsesocial.com/papers/6a7727c44fe2e6ffd8ec7418 https://doi.org/10.1046/j.1365-2125.2000.00207.x

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Implication

Low-dose ACEIs linked to lower angioedema rates in Nigerians than prior African-American estimates; hypothesis-generating and requires prospective confirmation before practice change.

Angioedema and cough in Nigerian patients receiving ACE inhibitors

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Angioedema and cough in Nigerian patients receiving ACE inhibitors

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider