0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.196.24.103. Please contact the publisher to request reinstatement.
Editor's Correspondence |

Angioedema and AT1 Receptor Blockers: Proceed With Caution

James A. MacLean, MD; Paul J. Hannaway, MD
Arch Intern Med. 2003;163(12):1488-1489. doi:10.1001/archinte.163.12.1488-a.
Text Size: A A A
Published online

Extract

I am writing in response to the case report of Drs Gavras and Gavras titled "Are Patients Who Develop Angioedema With ACE Inhibition at Risk of the Same Problem With AT1 Receptor Blockers?"1 The authors report a small sampling of patients who had angioedema with ACE inhibition, but who subsequently tolerated ARB medications without adverse effects. They state that there findings "should alleviate the concerns of physicians who may be reluctant to use an ARB in such patients, despite anticipated benefits." Further, they state, "We are not aware of any report about patients who developed angioedema while receiving ACE inhibition and who were subsequently treated with an ARB." A search of the literature would suggest otherwise. In the ARCHIVES in 1998, Van Rijnsoever et al2 reported 13 cases of angioedema in patients taking losartan. Three of these individuals had previously reported angioedema while using an ACE inhibitor. Warner et al3 reported that 32% of individuals who experienced angioedema with ARB use had experienced a prior episode of angioedema attributed to ACE inhibitor therapy. In a review of the safety of ARB use in patients with ACE-induced angioedema, Howes and Tran4 state that "angiotensin receptor antagonists cannot be considered to be a safe alternative therapy in patients who have previously experienced ACE inhibitor-associated angioedema."4 The incidence of angioedema in patients taking ARBs is clearly lower than that seen with ACE inhibitors. However, the use of ARBs in patients who have previously experienced angioedema with ACE inhibitors should be undertaken with caution.1,46

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 5

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();