title: Angiotensin-converting enzyme inhibitor-induced angioedema.
abstract: Angiotensin-converting enzyme inhibitors (ACE-I) are widely used, effective, and well-tolerated antihypertensive agents. The mechanisms by which those agents act can cause side effects such as decreased blood pressure, hyperkalemia, and impaired renal function. ACE-I can induce cough in 5%-35% and angioedema in up to 0.7% of treated patients. Because cough and angioedema are considered class adverse effects, switching treatment to other ACE-I agents is not recommended. Angioedema due to ACE-I has a low fatality rate, although deaths have been reported when the angioedema involves the airways. Here, we review the role of bradykinin in the development of angioedema in patients treated with ACE-I, as well as the incidence, risk factors, clinical presentation, and available treatments for ACE-I-induced angioedema. We also discuss the risk for recurrence of angioedema after switching from ACE-I to angiotensin receptor blockers treatment.
authors: Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel.
authors: Shira
authors: S
authors: Bezalel
authors: Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel.
authors: Keren
authors: K
authors: Mahlab-Guri
authors: Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel.
authors: Ilan
authors: I
authors: Asher
authors: Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel.
authors: Ben
authors: B
authors: Werner
authors: Departments of Medicine B, Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel. Electronic address: sthoeger@gmail.com.
authors: Zev Moshe
authors: ZM
authors: Sthoeger
mesh_terms: D000799:Angioedema / Q000139:chemically induced* / Q000628:therapy; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects; D003371:Cough / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D012307:Risk Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: ACE-I (angiotensin converting enzyme inhibitor); ARBs (angiotensin receptor blockers); Angioedema; Bradykinin; Cough; Ecallantide; Icatibant