Evidence map›Paper›PMID 37783509›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023

Impact of ACEIs and ARBs-related adverse drug reaction on patients' clinical outcomes: a cohort study in UK primary care.

Widya N Insani, Cate Whittlesea, Chengsheng Ju, Kenneth Kc Man, Matthew Adesuyan, Sarah Chapman, Li Wei

Abstract read

In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it

0cells of the map it votes in

9citing papers in PubMed, 1 pooled it

–field-weighted citation impact

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

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

Efficacy and safety evaluation of Allisartan Isoproxil in patients with hypertension: a meta-analysis.Frontiers in cardiovascular medicine · 2024
Pooled it
Cardiovascular medications and treatment outcomes in multiple myeloma: insights from phase III clinical trials.Scientific reports · 2026
Trial
Using Artificial Intelligence to Identify Patterns and Predictors of Adverse Drug Reactions in Cardiovascular Patients: A Comprehensive Narrative Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
Review
Combined ACEI and ARB therapy and ICU mortality in critically ill COVID-19 patients: a retrospective cohort study.Frontiers in pharmacology · 2026
Article
Comparison of Adverse Events Among Angiotensin Receptor Blockers in Hypertension Using the United States Food and Drug Administration Adverse Event Reporting System.Cureus · 2025
Article
Medication nonadherence - definition, measurement, prevalence, and causes: reflecting on the past 20 years and looking forwards.Frontiers in pharmacology · 2025
Review
Efficacy of Thymoquinone and Hesperidin in Attenuating Cardiotoxicity from 5-Fluorouracil: Insights from In Vivo and In Silico Studies.Toxics · 2024
Article
Recent Advances in the Therapeutic Potential of Carotenoids in Preventing and Managing Metabolic Disorders.Plants (Basel, Switzerland) · 2024
Review
Prevalence of cardiovascular drug-related adverse drug reactions consultations in UK primary care: A cross-sectional study.PloS one · 2024
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Widya N InsaniResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK; Centre of Excellence for Pharmaceutical Care Innovation, Department of Pharmacology and Clinical Pharmacy, Padjadjaran University, Bandung, Indonesia.ORCID 0000-0002-0066-9746

Cate WhittleseaResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID 0000-0002-4951-2272

Chengsheng JuResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID 0000-0001-7860-6262

Kenneth Kc ManResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Speical Administrative Region, China.ORCID 0000-0001-8645-1942

Matthew AdesuyanResearch Department of Practice and Policy, School of Pharmacy, University College London; Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-2058-4096

Sarah ChapmanInstitute of Pharmaceutical Science, King's College London, London, UK.ORCID 0000-0002-7612-1605

Li WeiResearch Department of Practice and Policy, School of Pharmacy, University College London; Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Speical Administrative Region, China.ORCID 0000-0001-8840-7267

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdverse drug reaction (ADR) related to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may negatively affect patients' treatment outcomes.

aimTo investigate the impact of ACEIs/ARBs-related ADR consultation on cardiovascular disease (CVD) events and all-cause mortality. DESIGN AND

settingPropensity score-matched cohort study of ACEIs/ARBs between 2004 and 2019 using UK IQVIA medical research data.

methodADR consultations were identified using standardised designated codes. Propensity scores were calculated based on comorbidities, concomitant medications, frailty, and polypharmacy. Cox's proportional hazard regression model was used to compare the outcomes between patients in ADR and non-ADR groups. In the secondary analysis, treatment- pattern changes following the ADR were examined and the subsequent outcomes were compared.

resultsAmong 1 471 906 eligible users of ACEIs/ARBs, 13 652 (0.93%) patients had ACEIs/ARBs- related ADR consultation in primary care. Patients with ACEIs/ARBs-related ADR consultation had an increased risk of subsequent CVD events and all- cause mortality in both primary prevention (CVD events: adjusted hazard ratio [aHR] 1.22, 95% confidence interval [CI] = 1.05 to 1.43; all-cause mortality: aHR 1.14, 95% CI = 1.01 to 1.27) and secondary prevention cohorts (CVD events: aHR 1.13, 95% CI = 1.05 to 1.21; all-cause mortality: aHR 1.15, 95% CI = 1.09 to 1.21). Half (50.19%) of patients with ADR continued to use ACEIs/ARBs, and these patients had a reduced risk of mortality (aHR 0.88, 95% CI = 0.82 to 0.95) compared with those who discontinued using ACEIs/ARBs.

conclusionThis study provides information on the burden of ADR on patients and the health system. The findings call for additional monitoring and treatment strategies for patients affected by ADR to mitigate the risks of adverse clinical outcomes.

Indexed as

Cardiovascular DiseasesDrug-Related Side Effects and Adverse ReactionsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCohort StudiesHumansPrimary Health CareUnited KingdomAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonistsadverse drug reactiondrug-related side effects and adverse reactionsprimary health care

Identifiers

PMID37783509

DOI10.3399/BJGP.2023.0153

PMCPMC10563001

What OpenQuestion holds

Textmetadata

LicenceCC BY

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.