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. 1996 Jul;60(1):8-13.
doi: 10.1016/S0009-9236(96)90161-7.

Black Americans have an increased rate of angiotensin converting enzyme inhibitor-associated angioedema

N J Brown  1 , W A Ray, M Snowden, M R Griffin
Affiliations

Black Americans have an increased rate of angiotensin converting enzyme inhibitor-associated angioedema

N J Brown et al. Clin Pharmacol Ther. 1996 Jul.

Abstract

Objective: To study the association of race and other patient characteristics associated with angiotensin converting enzyme (ACE) inhibitor-associated angioedema.

Methods: This was a retrospective cohort study of participants in the Tennessee Medicaid Program ( >or= 15 years of age) to whom ACE inhibitors had been prescribed from 1986 through 1992.

Results: We identified 82 patients with confirmed angioedema during 51,752 person-years of ACE inhibitor use, giving an overall rate of angioedema of 1.6 per 1000 person-years of ACE inhibitor use. After potential confounding factors were controlled for, the adjusted relative risk (RR) of angioedema among black American users of ACE inhibitors was 4.5 (95% confidence interval [CI] 2.9 to 6.8) compared with white subjects. In addition to race, other factors associated with a significantly increased relative risk in the entire population were the first 30 days of ACE inhibitor use (RR, 4.6; 95% CI, 2.5 to 8.5) compared to > 1 year of use, use of either lisinopril (RR, 2.2; 95% CI, 1.2 to 3.9) or enalapril (RR, 2.2; 95% CI, 1.4 to 3.5) compared to captopril, and previous hospitalization for any diagnosis within 30 days (RR, 2.0; 95% CI, 1.1 to 3.6). Neither ACE inhibitor dose nor concurrent diuretic use was associated with the risk of angioedema.

Conclusions: These data suggest that black Americans have a substantially increased risk of ACE inhibitor-associated angioedema compared with white subjects and that this increased risk cannot be attributed to an effect of dose, specific ACE inhibitor, or concurrent medications.

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Comment in

  • Race and angioedema.
    Burkhart GA. Burkhart GA. Clin Pharmacol Ther. 1997 Jun;61(6):700. doi: 10.1016/S0009-9236(97)90106-5. Clin Pharmacol Ther. 1997. PMID: 9209254 No abstract available.

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