ArticleFrontiers in allergy2025
Risk factors for angiotensin converting enzyme inhibitor angioedema in a South African population.
Article in Frontiers in allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Safety and tolerability of the ACE-inhibitor lisinopril among Nigerian adults with HIV: preliminary pilot data from a randomized clinical trial.Naunyn-Schmiedeberg's archives of pharmacology · 2026Trial
- A Cohort Study on Incidence and Factors Associated With Adverse Drug Reactions of Enalapril in Lusaka, Zambia.Pharmacology research & perspectives · 2026Article
- Article
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9 authors.
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Abstract
Introduction: Angiotensin converting enzyme inhibitors (ACEI) have proven mortality and morbidity benefit in hypertension, ischemic heart disease, heart failure, and renal disease and are among the most prescribed medications globally. ACEI angioedema (AE-ACEI) is a potentially life-threatening adverse drug reaction that is reported to occur more frequently in African American populations. However, the clinical profile of AE-ACEI is poorly characterized in diverse African populations. Methods: A case-controlled cohort study with enrolment of AE-ACEI cases and drug-tolerant controls in Cape Town, South Africa. Univariable and multivariable analysis was performed. Controls were defined as patients tolerating ACEI for a minimum of two years. Cases were defined as patients who had angioedema while using an ACEI, patients with a history of angioedema while not on an ACEI were excluded. Cases and controls were recruited from the same demographic areas, including both hospitals and clinics. Information regarding demographics and clinical history was captured via both in person interviews and folder review. Results: A total of 237 AE-ACEI cases, and 466 ACEI tolerant controls were enrolled from seven sites in Cape Town. Features of IgE-mediated immediate drug hypersensitivity were present in 24 cases, which excluded them from analysis. The median age was 58 years (IQR: 47; 67) and 57% were female. AE-ACEI cases more frequently had Black genetic ancestry compared to controls [53% (81/154), vs. 29% (146/407), Conclusion: In this South African population, Black genetic ancestry and calcium channel blocker use were the major risk factors for AE-ACEI. The majority of AE-ACEI occurred after several years of treatment, with most cases involving the lip and/or tongue. Long-term follow-up, genetic, and further mechanistic studies are warranted in additional diverse African populations.
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