Risk Factors for ACE Inhibitor-Induced Angioedema vs. Cough

The data showed that concomitant selective CCB use was more common among patients with angioedema
The data showed that concomitant selective CCB use was more common among patients with angioedema

A study published in the Annals of Pharmacotherapy found that factors such as smoking, male gender, concomitant selective calcium channel blocker (CCB) use, and longer treatment duration were associated with angiotensin-converting enzyme (ACE) inhibitor-induced angioedema more so than cough. 

Dry cough, a common adverse effect of ACE inhibitors, has been reported as a possible risk factor for the angioedema. Researchers from Sweden aimed to compare characteristics between patients with ACE inhibitor-induced angioedema and cough by determining risk factors that differ between these adverse reactions. The team obtained data on patients with ACE inhibitor-induced angioedema or cough from the Swedish database of spontaneously reported adverse drug reactions or from clinicians. The characteristics were compared for 168 patients with angioedema and 121 with cough only.  

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The data showed smoking and concomitant selective CCB use were more common among patients with angioedema (odds ratio [OR] 4.3, 95% CI: 2.1–8.9; P=0.000022) vs. cough (OR 3.7, 95% CI: 2.0–7.0; P=0.000017). In addition, angioedema was more frequent in male patients (OR 2.2, 95% CI: 1.4–3.6; P=0.00013) and these cases were associated with longer time to onset and higher doses vs. those with cough. 

A multivariable model found that smoking, concomitant CCB treatment, male gender, and time to onset made up 26% of the variance between the groups. 

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