ACE-Induced Angioedema Prevalence in African Americans

doctor with male patient
The prevalence of angioedema induced by ACE inhibitors was found to be higher in African Americans compared with other races.

The prevalence of angioedema induced by angiotensin-converting enzyme (ACE) inhibitors was found to be higher in African Americans compared with other races, according to research presented at the CHEST Annual Meeting’s virtual event, held October 18 to 21, 2020.

In this retrospective cohort study, the data of 1000 patients with confirmed angioedema who were admitted to or observed at a larger tertiary medical center between 2012 and 2018 were examined. Variables assessed included sex, race, and treatment with ACE inhibitors and/or angiotensin II receptor blockers (ARB) therapy at time of diagnosis.

In this cohort, 65.8% of patients with angioedema were African American, the other 26.1% were from other races. Of patients with angioedema, 60.6% were women, and approximately 50% were between the ages of 50 and 70 years.

Of 14,465 patients who were treated with ACE inhibitors or ARBs between 2012 and 2018, 2.2% had angioedema.

The incidence of angioedema among African Americans and Whites were 5% and 0.7%, respectively, corresponding to a 7 times higher incidence of the condition in the African American community.

”[T]he use of ACE inhibitors is increasing as a first-line of anti-hypertension agents in view of its potent blood pressure lowering effects and the mortality benefits it carries,” noted the study authors.  “Given the staggering increased incidence of ACE inhibitor-induced angioedema in African Americans, it is probably safer to choose other options for controlling hypertension,” they added. In cases in which ACE-inhibitors need to be used, clinicians should closely monitor potential side effects.


Asad H, Gohar A. Incidence of angiotensin-converting enzyme-associated angioedema among African Americans compared to other races. Presented at: CHEST Annual Meeting 2020; October 18-21, 2020. Presentation 1123A.