What is the clinical evidence from this study?

Study design: Cohort. Population: Conditions requiring ACE inhibitors (e.g., diabetes mellitus, hypertension) (n=424). Intervention: ACE inhibitors. Primary outcome: Incidence of discontinuation of ACE inhibitors due to cough.

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March 1, 2014Open Access

Incidence of discontinuation of angiotensin-converting enzyme inhibitors due to cough, in a primary healthcare centre in Singapore

Key Result

ACE inhibitor therapy was discontinued due to cough by 30.4% of newly prescribed patients in a Singapore primary healthcare cohort.

Study Design

Type

Cohort (n=424)

Multicenter

Structured PICO

What is the incidence of discontinuation of ACE inhibitors due to cough in an Asian primary care population?

Population

424 patients newly prescribed ACE inhibitors at a primary healthcare clinic in Singapore, followed for at least one year.

Exposure

ACE inhibitors (enalapril n=397, lisinopril n=27) prescribed for the first time.

Outcome

Incidence of discontinuation of ACE inhibitors due to coughsafety

The incidence of ACE inhibitor discontinuation due to cough in a Singaporean primary care cohort is approximately 30%, which is significantly higher than reported in Caucasian populations, suggesting ARBs may be a reasonable first-line alternative in this demographic.

Limitations

Methodology does not allow for determination of causal-effect relationships
Decision to discontinue was based on individual physician's clinical judgement
Cohort was only prescribed enalapril or lisinopril
Higher proportion of Malay patients than in the general Singapore population

Abstract

A total of 424 patients were identified during the study period. Out of the 424 patients, 129 (30.4%) discontinued the use of ACE inhibitors due to cough. Overall, 90 (21.2%) patients who were initially started on ACE inhibitors were eventually switched to angiotensin receptor blockers (ARBs).

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Cite This Study

Ng et al. (Sat,) conducted a cohort in Conditions requiring ACE inhibitors (e.g., diabetes mellitus, hypertension) (n=424). ACE inhibitors was evaluated on Incidence of discontinuation of ACE inhibitors due to cough. ACE inhibitor therapy was discontinued due to cough by 30.4% of newly prescribed patients in a Singapore primary healthcare cohort.

synapsesocial.com/papers/6a20914245811b7323cc4610 https://doi.org/https://doi.org/10.11622/smedj.2014034

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