Angioedema with Different Blood Pressure Medications (Antihypertensives)

Angioedema occurred in 0.13% of 42,000 studied patients (53 people):

- 70% were receiving lisinopril (an ACEI)
- 15% received chlorthalidone (a diuretic)
- 9% received doxazosin (an alpha blocker)
- 6% received amlodipine (a Ca++ channel blocker)

Can you prescribe ARB to a patient with ACE-inhibitor-related angioedema?

According to JACI, ARBs appear to be relatively safe when used in patient who develop angiodema with ACEI.

In a 2004 study, angioedema occurred during angiotensin receptor blocker (ARB) drug therapy in only 2 of 26 patients who had previously manifested angioedema during treatment with ACEI (Arch Intern Med 2004;164:910-3).

In a 2007 study of 6 patients with ACEI-induced angioedema, none of the patients developed angioedema when switched to angiotensin receptor blocker therapy (Ann Allergy Asthma Immunol 2007;98:57-63).

Explore Flickr tags and Google Images for angioedema.

References:

Incidence of angioedema with different antihypertension treatments. JACI, Beyond Our Pages, Volume 119, Issue 5, Pages 1287-1288 (May 2007).

Can you prescribe ARB to a patient with ACE-inhibitor-related angioedema?
Primary source: Diller et al. J Clin Hypertension 2006;8:649-56

Visceral angioedema due to angiotensin-converting enzyme inhibitor therapy - diagnosed with abdominal CT. CCJM, 2011.
Angioedema due to the renin inhibitor aliskiren. CCJM, 2011.
Image source: MorgueFile, public domain.