ACE Inhibitor-associated Angioedema

What is ACE Inhibitor-Associated Angioedema?

ACE inhibitor-associated angioedema, also known as ACE-IAE, is a condition caused by an allergic reaction to drugs that contain an angiotensin-converting enzyme (ACE) inhibitor. It is a rare, but serious, side effect of these drugs, which are commonly used to treat hypertension and heart failure.

ACE-IAE is characterized by swelling and inflammation of the face, lips, tongue, throat, and other soft tissues of the body. The swelling may lead to difficulty breathing, and if not treated promptly, can be life-threatening.

Risk Factors for ACE-IAE

The risk of ACE-IAE is increased for those with certain medical conditions, such as kidney disease or diabetes. The risk may also be higher in those taking higher doses of ACE inhibitors for a longer period of time.

Additionally, people who are of African descent, as well as women, appear to be at higher risk of developing ACE-IAE.

Symptoms of ACE-IAE

The symptoms of ACE-IAE can occur within hours or days after taking the medication. The most common sign is swelling of the face, lips, tongue, throat, and other soft tissues. Other symptoms may include:

  • Hives or itchy skin
  • Wheezing or difficulty breathing
  • Coughing
  • Hoarseness
  • Nausea or vomiting
  • Rapid heartbeat
  • Fainting

If any of these symptoms occur after taking an ACE inhibitor, it is important to seek medical attention immediately.

Treatment of ACE-IAE

If ACE-IAE is suspected, the offending drug should be stopped immediately. Treatment may include corticosteroids, antihistamines, and epinephrine. In some cases, a person may need to be intubated and given oxygen support.

Those who have experienced ACE-IAE should avoid ACE inhibitors in the future. Other medications, such as angiotensin-2 receptor blockers (ARBs) or calcium channel blockers, can be prescribed to help control blood pressure and heart failure.