Angiotensin-converting enzyme inhibitors (ACEIs) have replaced diuretics and Β-blockers as first-line agents for treating hypertension. Cough is a recognised side effect of ACEI treatment, and because of this, patients often have their medication changed to an angiotensin II receptor blocker (AIIRB). Both ACEIs and AIIRBs are associated with angioedema. We present a case of a late-onset angioedema associated with pyrexia and raised levels of inflammatory markers. We also discuss the causes and treatments of angioedema, and current controversies surrounding ACEIs and AIIRBs and their relation to anaphylaxis and angioedema.
(n=673) Incidence (discontinuation) Placebo
(n=339) Incidence Body As A Whole Orthostatic Effects () Syncope () Chest Pain () Fatigue () Abdominal Pain () Asthenia () Cardiovascular Hypotension () Orthostatic Hypotension () Angina Pectoris () Myocardial Infarction () Digestive Diarrhea () Nausea () Vomiting () Nervous/Psychiatric Dizziness () Headache () Vertigo () Respiratory Cough () Bronchitis () Dyspnea () Pneumonia () Skin Rash () Urogenital Urinary Tract Infection ()
PARADIGM-HF was a multinational, randomised, double-blind study of 8,442 patients comparing Entresto to enalapril, both given to adult patients with chronic heart failure, NYHA class II-IV and reduced ejection fraction (left ventricular ejection fraction [LVEF] ≤40%, amended later to ≤35%) in addition to other heart failure therapy. The primary endpoint was the composite of cardiovascular (CV) death or hospitalisation for heart failure (HF). Patients with SBP <100 mmHg, severe renal impairment (eGFR <30 ml/min/ m 2 ) and severe hepatic impairment were excluded at screening and therefore not prospectively studied.