Angiotensin-converting Enzyme Inhibitor-induced Angioedema

被引:66
作者
Bezalel, Shira [1 ]
Mahlab-Guri, Keren [1 ]
Asher, Ilan [1 ]
Werner, Ben [1 ]
Sthoeger, Zev Moshe [1 ]
机构
[1] Kaplan Med Ctr, Dept Med B, IL-76100 Rehovot, Israel
关键词
ACE-I (angiotensin converting enzyme inhibitor); Angioedema; ARBs (angiotensin receptor blockers); Bradykinin; Cough; Ecallantide; Icatibant; RECEPTOR BLOCKERS; ACE-INHIBITORS; RISK; BRADYKININ; PATHOPHYSIOLOGY; SYSTEM;
D O I
10.1016/j.amjmed.2014.07.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:120 / 125
页数:6
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