A report in the journal Hypertension shows that ACE inhibitors (angiotensin-converting enzyme inhibitors) cause angioedema, a sudden swelling of the face, lips, tongue or throat, about three times as often as other blood pressure drugs.
Dr Miller and colleagues looked at ACE inhibitors prescribed between 1999 and 2000, mainly lisinopril, fosinopril and captopril. Angioedema occurred at 1.97 cases per 1,000 people a year, against 0.47 in the same people before treatment and 0.51 in patients taking other blood pressure drugs; overall the risk was 3.56 times higher with ACE inhibitors.
Other factors raised the risk: being black, being female and having chronic heart failure or coronary artery disease, while the risk was lower in people with diabetes.
So groups at higher risk should be identified before ACE inhibitors are started, and patients should be told about this side effect. Swelling of the tongue or throat, or difficulty breathing, needs emergency care. ACE inhibitors still play an important role in preventing heart attacks, strokes and kidney damage in people at risk.
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