Knecht Stephanie E, Dunn Steven P, Macaulay Tracy E
Lexington VA Medical Center, Lexington, KY, USA.
University of Virginia Health System, Charlottesville, VA, USA.
J Pharm Pract. 2014 Oct;27(5):461-5. doi: 10.1177/0897190014546101. Epub 2014 Aug 14.
Angiotensin inhibitors have been extensively evaluated in clinical trials and have demonstrated significant reductions in morbidity and mortality following myocardial infarction and stroke, as well as in patients with heart failure or who are at risk of cardiovascular disease. Further, both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are frequently prescribed for the treatment of hypertension and to preserve renal function in patients with diabetes mellitus and chronic kidney disease. Angioedema is a known, but rare, adverse effect of ACEIs and ARBs. Therefore, it is important for clinicians to have a thorough understanding of risks and benefits of prescribing these medications, particularly in patients with a history of angioedema. This review describes the literature evaluating the incidence and cross-reactivity of angioedema with ACEIs and ARBs in order to provide guidance for clinical decision making.
血管紧张素抑制剂已在临床试验中得到广泛评估，并已证明在心肌梗死和中风后以及心力衰竭患者或有心血管疾病风险的患者中，发病率和死亡率显著降低。此外，血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）都经常被用于治疗高血压，并保护糖尿病和慢性肾病患者的肾功能。血管性水肿是ACEIs和ARBs已知但罕见的不良反应。因此，临床医生全面了解开具这些药物的风险和益处非常重要，尤其是对于有血管性水肿病史的患者。本综述描述了评估血管性水肿与ACEIs和ARBs的发生率及交叉反应性的文献，以便为临床决策提供指导。
