Diabetes and ACE-induced Angioedema

Q: Diabetes increases the risk of ACE inhibitor-induced angioedema.

A) True

B) False

Answer: B

Diabetes is found to have a protective effect in Angiotensin-converting enzyme (ACE) inhibitor-induced angioedema. The underlying mechanism is unknown, though it has been proposed that diabetes increases levels of the enzyme Dipeptidyl peptidase-4 (DPP-IV), which breaks down bradykinin. Bradykinin is considered to be the main culprit in inducing angioedema due to ACE inhibitors.

Some known risk factors for ACE inhibitor-induced angioedema are older age, Aspirin or NSAID use, female sex, Smoking, history of allergies, Coronary artery disease (CAD), and history of ACE inhibitor-induced cough.

#pharmacology

#endocrinology

References:

1. Miller DR, Oliveria SA, Berlowitz DR, et al. Angioedema incidence in US veterans initiating angiotensin-converting enzyme inhibitors. Hypertension 2008; 51:1624.

2. Byrd JB, Touzin K, Sile S, et al. Dipeptidyl peptidase IV in angiotensin-converting enzyme inhibitor associated angioedema. Hypertension 2008; 51:141.

3. Ali HA, Lomholt AF, Mahmoudpour SH, Hermanrud T, Bygum A, von Buchwald C, Jakobsen MA, Rasmussen ER. Genetic susceptibility to angiotensin-converting enzyme-inhibitor induced angioedema: A systematic review and evaluation of methodological approaches. PLoS One. 2019 Nov 11;14(11):e0224858. doi: 10.1371/journal.pone.0224858. Erratum in: PLoS One. 2019 Dec 19;14(12):e0227056. doi: 10.1371/journal.pone.0227056. PMID: 31710633; PMCID: PMC6844479.