Evidence map›Paper›PMID 16679330›Full record

SynthesisBMJ (Clinical research ed.)2006

Systematic review and meta-analysis of ethnic differences in risks of adverse reactions to drugs used in cardiovascular medicine.

Sarah E McDowell, Jamie J Coleman, R E Ferner

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 9 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 9 syntheses or guidelines pooled it, 247 citations in OpenAlex.

  1. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
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  6. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline
  7. Pooled it
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  10. Trial
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  14. Review
  15. Pitfalls in the pharmacotherapy of hypertension.Clinical medicine (London, England) · 2026
    Review
  16. Article
  17. Review
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  20. Article

32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Sarah E McDowellWest Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Birmingham B18 7QH.
Jamie J Coleman
R E Ferner
Birmingham City Hospital · GBUniversity of Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo review the evidence for ethnic differences in susceptibility to adverse drug reactions (ADRs) to cardiovascular drugs.

designSystematic review and meta-analysis. DATA SOURCES: We searched Medline and Embase to March 2005. Reference lists of identified articles were hand searched for further relevant articles. REVIEW

methodsStudies were eligible for inclusion if they included at least two ethnic groups and one or more ADRs. We excluded case reports and case series.

results564 studies contained some description of ethnicity and an ADR, and 132 of them related to cardiovascular therapies. Twenty four studies provided data for ADRs for at least two ethnic groups and were therefore eligible for inclusion. In pooled analyses the relative risk of angio-oedema from angiotensin converting enzyme (ACE) inhibitors in black compared with non-black patients was 3.0 (95% confidence interval 2.5 to 3.7); the relative risk of cough from ACE inhibitors was 2.7 (1.6 to 4.5) in East Asian compared with white patients; and the relative risk of intracranial haemorrhage with thrombolytic therapy was 1.5 (1.2 to 1.9) in black compared with non-black patients.

conclusionPatients from different ethnic groups have different risks for important ADRs to cardiovascular drugs. Ethnic group may therefore be one determinant of harms of a given treatment in the individual patient, either because it acts as a surrogate measure of genetic make up or because cultural factors alter the risk. Data are sparse, and regulators should consider asking for better data before licensing.

Indexed as

Adverse Drug Reaction Reporting SystemsAngiotensin-Converting Enzyme InhibitorsBiasCardiovascular AgentsCardiovascular DiseasesConfounding Factors, EpidemiologicEthnopharmacologyHumansRisk FactorsThrombolytic TherapyAngiotensin-Converting Enzyme InhibitorsCardiovascular Agents

Identifiers

PMID16679330
PMCPMC1463974
OpenAlexW2113158945

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.