Angioedema and angiotensin‐converting enzyme inhibitors: Are demographics a risk?

Abstract

This study represents the largest series of patients with angioedema. Although retrospective in nature, the data show that black patients are at a higher risk for ACEI-induced angioedema.

Epidemiology of ACE Inhibitor Angioedema Utilizing a Large Electronic Health Record

“…Risk factors associated with ACEI associated angioedema have been reported in the literature, including Black race 18,19 and female sex. 20 Diabetes and obesity have been shown to increase severity of angioedema events.…”

Angiotensin-converting Enzyme Inhibitor-induced Angioedema – A Dangerous New Epidemic

“…In a specialised out-patient setting the incidence was found to be 11% (17). People of African origin have an up to 3 times higher risk of angioedema when treated with ACEi, which in some cases are caused by a genetic polymorphism (18,19). Female gender, a history of smoking and age > 65 years also seem to be risk factors (13,20).…”

“…They did also note a significant interpersonal difference in severity of symptoms, causing them to hypothesise upon that some people might be more predisposed to angioedema after ingestion of ACEi. This might be true, but has so far only been proven in black patients compared to Caucasians (18). Aminopeptidase P is the main enzyme responsible for degrading bradykinin when ACE is inhibited, and a decreased activity could theoretically signify an increased risk of angioedema due to bradykinin accumulation.…”

Angioedema: A Review of 367 Episodes Presenting to Three Tertiary Care Hospitals

“…[3][4][5][6] It is particularly common in African Americans. 5,[7][8][9][10][11] An increase in hospitalizations for angioedema has been reported in New York State since 1990. 7 Of interest to otolaryngologists, the principal cause of morbidity and mortality in patients with angioedema is airway compromise.…”