Q: 52 year old male with established diagnosis of Hereditary angioedema is admitted to ICU for unrelated reason. Which one group of anti-hypertensives should be avoided?

Answer:  ACE-Inhibitors

Hereditary angioedema is an autosomal dominantly inherited blood disorder that causes episodic attacks of swelling that may affect the face, extremities, genitals, gastrointestinal tract and upper airways. Hereditary angioedema  is caused by a deficiency of the C1 esterase inhibitor, a protein of the complement system.

Treatment with ACE inhibitors is contraindicated, as it can lead to bradykinin accumulation, which can precipitate disease episodes.