(Philly.com) — The blood-pressure-lowering drugs known as ACE inhibitors are a mainstay of treatment for many diseases.
But with growing use of these heart-helping medications, more and more patients are winding up in emergency rooms with a rare side effect that most have not been warned about: swelling around the face and neck.
In the worst cases, the patient’s tongue and throat become hugely bloated, closing the airway. No medications can slow or reverse this swelling, called angioedema. To prevent suffocation, a tube must be inserted through the patient’s nose, mouth, or an incision in the throat – maneuvers that are tougher than they appear on TV shows.
“I’ve seen a number of deaths because you just can’t get the tube in,” said James R. Roberts, director of emergency medicine at Mercy Philadelphia Hospital and Mercy Fitzgerald Hospital, which see more than a case a week.
Roberts recently published a letter in the American Journal of Cardiology to call attention to what he considers an “unrecognized epidemic.”
He would like the U.S. Food and Drug Administration to add its most stringent alert, a “black-box warning,” to prescribing information to prod doctors to warn about angioedema. Although studies show that fewer than 1 percent of patients will develop it – even fewer will have breathing problems – that’s still a vast group, given that tens of millions of Americans now take the drugs for hypertension, heart disease, heart failure, stroke, diabetes, and kidney disease.
Roberts’ idea is not new. In 2002, Boston University emergency medicine physician James A. Feldman formally petitioned the FDA for a black-box warning. The agency refused, saying the labeling already had enough “discussion” of angioedema.
(12 votes, average: 4.75 out of 5)
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This side effect presents more like an allergic reaction not a side effect. Do symptoms appear within a few hours, few days or longer after administering? Also th link to read more on this topic is rejected with a 404 error code.
Clyde, I took ACE inhibitors for a couple of years and always had the cough. I also have asthma, BTW. Finally, I got a bad upper respiratory virus and that night I almost stopped breathing several times. When I stopped using the ACE inhibitors, my problems went away. I think people who have “the cough” from these drugs should not continue to use them but find an alternative.
Yes, I’d like to know more about this, and the link didn’t work for me, either.
I agree with Clyde. Need more infro on this. I also got a 404 error code.
(Ditto w/ Clyde re. the error code.) My question: has angioedema occurred in subjects (like me) who have used an ACE inhibitor for years without any such side effect?
I had to get off the ACE inhibitors BECAUSE of the side effects……..along with all the drug classes for HBP……….I have severe side effects……..wish there were MORE alternative things to do.
Yes , there are things you can do to lower your BP besides taking medications. First, you can try to shed extra pounds if you are overweight, second you should follow a regular program of aerobic exercise (if your doctor allows it), third, follow a strict diet that includes lots of fresh vegetables and fruits ( to increase your potassium and magnesium intake) and also stop eating canned foods and enriched flour breads and pastries and switch to whole grains, also, avoid sugar at all costs. Eat fish like salmon and sardines at least twice a week and limit your consumption of red meat. All of these sounds familiar?, well it may be…just follow it!.
Well, those standard recommendations are all fine, Emiliano; however, following them will not eliminate BP spikes. Each case is individualized, e.g., I am perfectly fit, I am a vegan (comsume ONLY plant foods) with completely sodium-free diet, I am a swimmer, biker, etc. (generally, physically active), and I use Resperate. BUT, I have to continue taking meds to keep my BP under control. What can you recommend me doing???
Salmon and sardines at least twice a week. Watch out for gout! It is extremely painful 24 hours/ day and takes months to get rid of. Hydrochlorothiazide (“water pill”) is a top contributor for gout as well. I found that checking urine ph and working to adjust the ph to slight alkalinity is beneficial.
My BP is hard to control for any length of time. My Dr. has recently found the concoction to get my BP the lowest it has been, 156/78. This is wonderful but I am not quite sure it is worth the side effects. After reading this article on angioedema, my side effect seems trivial yet it controls my life. I am so fatigued and tired most of the day that all I can do is sleep. I want to throw all of these meds down the drain but my better half tells me “NO”. Is there anything I can do to help me stay awake with all these meds?
Try Resperate,this is a non drug respiration rate control method that could be very effective. One of the problems with these and other drugs is that that your body adapts to them and after a while using them (specially as in your case, it is a long time usage), it becomes hard and sometimes very dangerous (as in the case of beta blockers) to withdraw from them “cold turkey”, this quiting process should not be attempted without proper medical supervision, but it can be done. Due to this adaptation to the drug, the blood pressure would tend to skyrocket when the medication is quit abruptly (probably not because you needed it, in the first place,but because your cardiovascular system, specifically your blood vessels, have adapted to the restrain of the drug attempting to counteract its action, and this counteracting adaptation is what drives up the BP once the drug is withdrawn suddenly).
Is there a time period of importance bringing this on? What about people that have been on it for 10-20 years? Please provide more information, this is very important for longtime users. Also, the link doesn’t work as previously stated.
Adding a comment about this nasty side effect of the ACE inhibitors: what would anyone expect from interfering with a natural process evolved after millions of years of natural selection among the different organisms, to control something so vital as the blood pressure?. The Angiotensin Converting Enzyme (ACE) is not the devilish contraption we have been made to believe by Big Pharma, just like Cholesterol is not the demonized poison despised by the statins manufacturers. ACE is just an enzyme required by a vital step in the Renin Angiotensin system evolved to help in the regulation of our blood pressure (same system exists in all mammals), so here we are tinkering with a delicate biochemical process and then we try to minimize the consequences!. Would not be much wiser to first change our lifestyles to prevent or correct the development of HBP before resorting to these dangerous drugs?.
Many of us have changed our lifestyles, doing all the recommended things. It helps, but not enough. We need more help, that is why we turn to medications.
There is something else about the levels at which modern day medicine considers the normal average blood pressure to fall into a HBP category. First of all, there are and should be differences in what can be considered as “normal” BP levels according to the age range of each individual, that is to say, it is not logical to consider the 120/80 (and even less!) to be the “normal” desirable level for all age groups and if not, force the cardiovascular system to achieve it through drugs (something that is seldom achieved, as can be attested by many patients). The “one size fits all approach” is wrong because it pretends to ignore the subtle changes in the arterial structure that come as consequence of the aging process,plainly and simply: arteries tend to become stiffer and less elastic as we age and this is a natural process that can not and is not reverted by any anti-hypertensive drug, period (if someone claims the opposite he or she doesn’t know very much about human biology). If 120/80 is “normal” for a young, fit, healthy weighted individual, it is somehow preposterous to affirm the same for a 60’s, 70’s or even 80’s individual. Besides, it has not been proved (again the pharmaceuticals will come with thousands of rigged trials to show the opposite, but of course, they have a very big economic interest in showing precisely that)that these drugs prolong the patient’s lifespans by any significant amount of time while simultaneously subjecting them to many unbearable “side effects”. All of these is one of the consequences of living in “Overdosed America”, as Dr. John Abramson wrote in his excellent book with the same title.
You are the first person to make a good case for what I have been saying for a long time, when we age and get old we can not eat the same greasy foods or amounts as when we were young, we can not run as fast or as hard, we can not lift the same weights as when we were young or drink as much liquor or have the same sexual prowess as when young or have the same mental sharpness or agility or reflexes, everything slows down, weakens, suffers, deteriorates, is expected, we accept it as natural, de do not take drugs to allow us to jump like kangaroos or like when we were young, no, we understand it as a natural process of aging.
But when we get to the blood pressure business that is totally different thing, no understanding here, it has to stay perfect like when a teenager, now days as soon as we walk into a doctors office the first thing one gets slapped with is with a blood pressure cuff, and from there on the BP dance starts, in your 40’s 50’s 60’s 70’s it has to stay 120/80 or the medical establishment will drug you down to a rheumatic zombie state or else.
If you tell your doctor you cant eat half a dozen pork chops like you used to he will tell off course, what do you expect at your age? But when BP is high you know the story. What happened to the old doctors understanding of blood pressure being 100 plus your age rule? I also could not help but notice this new trend were the BP medication is given for shorter and shorter periods of time before we have to $ee the doctor again for a refill.
I was prescribed Altace (which is an ACE inhibitor) approximately 2 years ago. I had been on beta blockers for several years but my blood pressure was never really controlled with the beta blockers. So, my doctor prescribed Altace and within 24 hours my heart rate went to 220 and my blood pressure rose to 230/180 and had to call 911 because I thought I was going to die. The paramedics saved my life that night. My throat had closed up and it was a severe allergic reaction as I was told by the emergency doctor and they warned me never to take this drug again. I guess my doctor knew of the warnings of the drug when I spoke to her about it and I was extremely upset with her for prescribing it to me. Since then I am now back on the beta blockers at a higher dose and do not have any more problems.
Our apologies. The link has been corrected and you can view the rest of the article. Enjoy!
An 85-year old man told me that his doctor suggested that he was unable to take a reliable blood pressure due to his age and ageing blood vessels being ‘sticky’ or something to that effect. When I asked him what he and his doctor are doing about this he said “nothing, still alive and doing well.”