Abstract:
OBJECTIVE:To find out whether enalapril or ramipril causes the sensitivity of the cough reflex to change or symptomatic cough to develop in patients with hypertension. DESIGN:Prospective, placebo controlled, double blind, randomised crossover study. SETTING:Academic units of clinical pharmacology and medicine. PATIENTS:20 Patients (nine men and 11 women) who needed to take angiotensin converting enzyme inhibitors to control hypertension. INTERVENTIONS:All patients received enalapril 10 mg daily, ramipril 10 mg daily, or placebo daily for one week in random order, with a washout period of at least one week between treatments. For assessment of sensitivity of the cough reflex the patients inhaled various concentrations of capsaicin solution in random order. MAIN OUTCOME MEASURES:Measurement of the doses of capsaicin required to cause two or more and five or more coughs or the development of a symptomatic cough. RESULTS:Blood pressure, symptoms of cough, and the sensitivity of the cough reflex to inhaled capsaicin were recorded at the start of the study and before and at the end of each treatment period. Plasma urea and creatinine concentrations and angiotensin converting enzyme activity were measured at the start of the study and the end of each treatment period. Data were analysed by two way analysis of variance. Mean blood pressure was 159/97 mm Hg at the start of the study and 152/92, 143/88, and 147/86 mm Hg after treatment with placebo, enalapril, and ramipril respectively. Mean (SE) plasma angiotensin converting enzyme activity was 2.2 (0.2) mmol/l/h after treatment with placebo and fell significantly to 1.3 (0.1) mmol/l/h and to 0.4 (0.1) mmol/l/h after treatment with enalapril and ramipril respectively. No patient complained of cough while taking placebo but three women complained of cough when taking both enalapril and ramipril. The mean (95% confidence interval) lowest dose of capsaicin causing two or more coughs was 2.4 (1.5 to 4.0), 1.8 (1.12 to 2.82), and 2.2 (1.7 to 3.0) nmol after treatment with placebo, enalapril, and ramipril respectively; none of these changes were significant. The lowest dose of capsaicin causing five or more coughs was 18.9 (13.9 to 25.8), 14.4 (8.4 to 24.5), and 15.3 (10.8 to 21.2) nmol respectively; none of these changes were significant. The three patients who complained of cough had normal sensitivity to capsaicin after treatment with placebo but had a considerably increased sensitivity after treatment with enalapril and ramipril. CONCLUSIONS:Both enalapril and ramipril increase the sensitivity of the cough reflex appreciably in patients who complain of cough during treatment, but they do not change the se
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
McEwan JR,Choudry N,Street R,Fuller RWdoi
10.1136/bmj.299.6690.13subject
Has Abstractpub_date
1989-07-01 00:00:00pages
13-6issue
6690eissn
0959-8138issn
1756-1833journal_volume
299pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN:Observational study. SETTING:Hospitals (n = 1487) participating in the Get With The Guidelines (GWTG)-Stroke program in the United States, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3786
更新日期:2015-07-31 00:00:00
abstract:OBJECTIVE:To assess the education and workload of preregistration house officers in the four Thames regions. DESIGN:Postal questionnaire. SETTING:Teaching and non-teaching hospitals in the four Thames regions. PARTICIPANTS:1064 Preregistration house officers. RESULTS:Response rate was 70% (740 replies). Nine per ce...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6726.713
更新日期:1990-03-17 00:00:00
abstract:OBJECTIVE:To examine the effects of involving patients in the planning and development of health care. DATA SOURCES:Published and grey literature. STUDY SELECTION:Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION:Qualitative review of papers describing ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.325.7375.1263
更新日期:2002-11-30 00:00:00
abstract::Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples'...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6962.1137
更新日期:1994-10-29 00:00:00
abstract:OBJECTIVE:To compare the functional results after displaced fractures of the femoral neck treated with internal fixation or hemiarthroplasty. DESIGN:Randomised trial with blinding of assessments of functional results. SETTING:University hospital. PARTICIPANTS:222 patients; 165 (74%) women, mean age 83 years. Inclusi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39399.456551.25
更新日期:2007-12-15 00:00:00
abstract:PROBLEM:Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN:Pilot implementation of the first programme for prevention of mother to child transmission of HIV...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.329.7475.1147
更新日期:2004-11-13 00:00:00
abstract:OBJECTIVES:To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation. DESIGN:Meta-analysis of prospective cohort studies. DATA SOURCES:Searches of Medline and Embase databases for articles published up to January 2012 using...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e1454
更新日期:2012-03-15 00:00:00
abstract::Objective To estimate the incidence and prevalence of resistant hypertension among a UK population treated for hypertension from 1995 to 2015.Design Cohort study.Setting Electronic health records from the UK Clinical Practice Research Datalink in primary care.Participants 1 317 290 users of antihypertensive drugs with...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3984
更新日期:2017-09-22 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs. DESIGN:Retrospective cohort and nested case-control study. SETTING:Umbria region, Italy. PARTICIPANTS:400 000 current, recent, and past users (almost 2 million prescriptions) o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7405.18
更新日期:2003-07-05 00:00:00
abstract:OBJECTIVE:To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN:Longitudinal analysis. SETTING:35 medical facilities of Kaiser Permanente Northern California, 1997-2007. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c1898
更新日期:2010-05-11 00:00:00
abstract:OBJECTIVE:To quantify an association between acute kidney injury and use of high potency statins versus low potency statins. DESIGN:Retrospective observational analysis of administrative databases, using nine population based cohort studies and meta-analysis. We performed as treated analyses in each database with a ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,多中心研究
doi:10.1136/bmj.f880
更新日期:2013-03-18 00:00:00
abstract:OBJECTIVE:To examine the relation between energy intake in childhood and adult mortality from cancer. STUDY DESIGN:Cohort study. SETTING:16 rural and urban centres in England and Scotland. SUBJECTS:3834 people who took part in Lord Boyd Orr's Carnegie survey of family diet and health in prewar Britain between 1937 a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7130.499
更新日期:1998-02-14 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.d2202
更新日期:2011-04-26 00:00:00
abstract::The identification of the gene for cystic fibrosis has led to the possibility of population based screening for carriers of cystic fibrosis to identify couples at risk of having an affected child. Pilot studies have shown that screening is feasible and does not cause untoward anxiety, though the uptake of testing vari...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6908.849
更新日期:1993-10-02 00:00:00
abstract:OBJECTIVE:To determine whether short-term, oral low dose prednisolone (< or = 15 mg daily) is superior to placebo and non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN:Meta-analysis of randomised trials of oral corticosteroids compared with placebo or a non-steroidal anti-inflammatory...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.316.7134.811
更新日期:1998-03-14 00:00:00
abstract:OBJECTIVE:To determine whether patients with unexpected prehospital cardiac arrest could be identified in whom ambulance resuscitation attempts would be futile. DESIGN:Review of ambulance and hospital records; detailed review of automated external defibrillator rhythm strips of patients in whom no shock was advised. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.6996.49
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:To determine, using research on duloxetine for major depressive disorder as an example, if there are inconsistencies between protocols, clinical study reports, and main publicly available sources (journal articles and trial registries), and within clinical study reports themselves, with respect to benefits an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g3510
更新日期:2014-06-04 00:00:00
abstract:OBJECTIVES: To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Conge...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.i4721
更新日期:2016-09-13 00:00:00
abstract:OBJECTIVES:To determine the prevalence of workplace bullying in an NHS community trust; to examine the association between bullying and occupational health outcomes; and to investigate the relation between support at work and bullying. DESIGN:Questionnaire survey. SETTING:NHS community trust in the south east of Engl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7178.228
更新日期:1999-01-23 00:00:00
abstract:OBJECTIVES:To evaluate the risk of venous thromboembolic events associated with the use of progestin-only contraception and whether that risk differs with the mode of drug delivery (oral, intrauterine, or depot injection). DESIGN:Systematic review and meta-analysis of randomised controlled trials and observational stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e4944
更新日期:2012-08-07 00:00:00
abstract:OBJECTIVE:To assess the effect of high dose inhaled corticosteroids on skin. DESIGN:Cross sectional study of patients receiving treatment for chest diseases. SETTING:Outpatient chest clinic in a teaching hospital. PATIENTS:68 Patients divided into four groups of similar age--namely, 15 receiving long term oral predn...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6739.1548
更新日期:1990-06-16 00:00:00
abstract:OBJECTIVE:To evaluate the associations between personal use of permanent hair dyes and cancer risk and mortality. DESIGN:Prospective cohort study. SETTING AND PARTICIPANTS:117 200 women enrolled in the Nurses' Health Study, an ongoing prospective cohort study of female nurses in the United States. The women were free...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m2942
更新日期:2020-09-02 00:00:00
abstract:OBJECTIVE:To describe temporal trends in the time interval between first and second attempts at defibrillation and the association between this time interval and outcomes in patients with persistent ventricular tachycardia or ventricular fibrillation (VT/VF) arrest in hospital. DESIGN:Retrospective cohort study SETTI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i1653
更新日期:2016-04-06 00:00:00
abstract:OBJECTIVES:To determine the strength of evidence for the effectiveness of mental health interventions for patients with three common somatic conditions (chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain). To assess whether results obtained in secondary care can be extrapolated to primary care an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.325.7372.1082
更新日期:2002-11-09 00:00:00
abstract:OBJECTIVE:To assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments. DESIGN:Prospective study over six weeks. SETTING:Teaching hospital casualty x ray department. PATIENTS:3394 consecutive patients referred for radiography. INTERVENTIONS:Radiogr...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.302.6776.568
更新日期:1991-03-09 00:00:00
abstract:OBJECTIVES:To investigate the effect of milk supplementation on total body bone mineral acquisition in adolescent girls. DESIGN:18 month, open randomised intervention trial. SUBJECTS:82 white girls aged 12.2 (SD 0.3) years, recruited from four secondary schools in Sheffield. INTERVENTION:568 ml (one pint) of whole o...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.315.7118.1255
更新日期:1997-11-15 00:00:00
abstract:OBJECTIVE:To assess the effect of screening for cervical intraepithelial neoplasia on the incidence of and mortality from invasive squamous cell carcinoma of cervix in north east Scotland and to discover why cases of invasive cancer still occur. DESIGN:(a) Analysis of data on cases of cervical intraepithelial neoplasi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6941.1407
更新日期:1994-05-28 00:00:00
abstract:OBJECTIVES:To assess the performance of a panel of common single nucleotide polymorphisms (genotypes) associated with type 2 diabetes in distinguishing incident cases of future type 2 diabetes (discrimination), and to examine the effect of adding genetic information to previously validated non-genetic (phenotype based)...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4838
更新日期:2010-01-14 00:00:00
abstract::According to a London physician, women with epilepsy taking antiepileptic drugs can take combined oral contraceptives (OCs). It is usual to recommend a combined OC preparation containing at least 50 mcg of estrogen (Ovran) from patients taking enzyme-inducing antiepileptic drugs; this can be increased to 60 mcg by ta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.307.6902.492
更新日期:1993-08-21 00:00:00
abstract:OBJECTIVES:To determine whether over the counter cough medicines are effective for acute cough in adults. DESIGN:Systematic review of randomised controlled trials. DATA SOURCES:Search of the Cochrane Acute Respiratory Infections Group specialised register, Cochrane Controlled Trials Register, Medline, Embase, and the...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.324.7333.329
更新日期:2002-02-09 00:00:00