Severe Angioedema after Long-Term Use of an Angiotensin-Converting Enzyme Inhibitor

Excerpt

To the Editor: Angiotensin-Converting enzyme (ACE) inhibitors have been in clinical use since 1980. They are effective antihypertensive agents with a good safety profile (1). Reported side effects include cough, azotemia, hypotension, hyperkalemia, and angioedema. Studies (2, 3) have reported the incidence of angioedema associated with the use of ACE inhibitors to be between 0.1% and 0.2%, but they did not emphasize the potential for severe life-threatening angioedema after long-term use. Another study (4) mentions a patient who was continued on the ACE inhibitor lisinopril even after a transient episode of angioedema. We report the case of a patient who