CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

July 13th, 2012

Meta-Analysis: ACE Inhibitors Associated with Lower Pneumonia Risk

Angiotensin-converting–enzyme inhibitors may offer some protection against pneumonia, according to a BMJ meta-analysis. An editorialist isn’t so sure.

Researchers looked at almost 40 studies — including cohort studies, case-control studies, and randomized trials — that reported pneumonia outcomes after use of ACE inhibitors, angiotensin-receptor blockers, and control treatments. The data revealed that ACE inhibitors conferred a roughly 30% decrease in risk for pneumonia, when compared with ARBs or control treatments. The effect was particularly pronounced in Asian patients.

The authors speculate that the cough often associated with ACE inhibitors may actually play a part in the protective effect by clearing respiratory tract secretions.

An editorialist finds it “difficult to agree” with the authors’ enthusiasm. She calls for more studies “before we advise patients to put up with their cough because it may prevent them from getting pneumonia.”

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3 Responses to “Meta-Analysis: ACE Inhibitors Associated with Lower Pneumonia Risk”

  1. Jean-Pierre Usdin, MD says:
    July 17, 2012 at 4:09 am

    So Simple
    So easy.
    in my opinion the editorialist is right: “difficult to agree!”
    I am surprised that scientific comittee of one of the leaders of Internal Medicine periodics: British Medical Journal, accepted the conclusions “as cough clean lungs and prevent pneumonia!”
    why not going deeper via potential effect of bradykinin (for example)?
    too easy, too simple, isn’it? what use in my daily clinical practice?

  2. Robin Motz, M.D., Ph.D. says:
    July 17, 2012 at 10:05 am

    So let’s do a forward clinical study. A meta-analysis is only useful for generating a hypothesis, and not for generating a clinical guideline.

  3. Jean-Pierre Usdin, MD says:
    July 22, 2012 at 3:33 pm

    So What?
    it is not the problem of meta-analysis.
    in my opinion the editorial board of a leading periodic should not accept a paper without scientific conclusion and no utility in our practice.