Evaluation of angiotensin converting enzyme inhibitors (ACEI) induced side effects in allergology department

Abstract

Background and aim. ACEIs are extensively used in cardiac diseases and among their main side effects there are dry cough and angioedema. The aim of this study is to evaluate the patients who are presenting to an allergologist for a suspicion of side effects induced by ACEI. Material and methods. Forty-two patients with arterial hypertension treated with ACEI, who have presented dry cough and/or angioedema as side effects, were included. The patients were evaluated between 2014 and 2016 in one allergology department from Cluj-Napoca. The data were collected from the files and were statistically analyzed using SPSS v.21. The allergological evaluation included anamnesis data that were recorded in patients files and the results of skin prick test performed at the initial presentation. Results. Females were more likely than men to have side effects (64.3% versus 35.7%). Half of the patients were treated with perindopril. Most of the patients (59.5%) were referred to the allergology department for dry cough. Angioedema was more commonly observed in men, while cough was a frequent side effect in women, with no statistical significance (p = 0.150). There is no correlation between the used ACEI and the type of side effect (p = 0.45) or the number of angioedema episodes (p = 0.51). The persistence of the symptoms in spite of treatment cessation was observed in case of perindopril and enalapril (p = 0.05) and in case of atopy presence (p = 0.03). Conclusions. Cough and angioedema are common side effects of the whole class of ACEI. The type of adverse events might be correlated with the patient’s gender. The presence of atopy may increase the risk of symptoms persistence.