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

OBJECTIVES: The use of angiotensin-converting enzyme inhibitors (ACEI) has become the leading cause of acquired angioedema. Previous studies have suggested that certain patient populations may be at a higher risk for ACEI-induced angioedema. The objective of this study was to evaluate any demographic associations. STUDY DESIGN: A retrospective chart review. MATERIALS AND METHODS: Angioedema patients from 1999 to 2004 treated at a tertiary care hospital were reviewed. Demographics, inciting factors, and comorbid conditions were examined. RESULTS: One hundred eighty-two patients met inclusion criteria. Sixty-three percent of patients with angioedema had ACEI triggers. Eighty-one percent of all ACEI angioedema occurred in black patients. Of all angioedema patients, 70% (95% confidence interval [Cl], 62%-78%) of black patients noted an ACEI as the inciting agent compared with 44% (95% Cl, 30%-59%) in other patient groups. Black patients were 3.03 times more likely to have angioedema from an ACEI than all other patient groups (95% Cl, 1.54-5.94). CONCLUSION: 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. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.