Journal ArticleDOI
Incidence and Predictors of Angioedema in Elderly Hypertensive Patients at High Risk for Cardiovascular Disease: A Report From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Linda B. Piller,Charles E. Ford,Barry R. Davis,Chuke Nwachuku,Henry R. Black,Suzanne Oparil,Tamrat M. Retta,Jeffrey L. Probstfield +7 more
TLDR
The occurrence of angioedema in the angiotensin‐converting enzyme inhibitor arm corresponds with previously reported angioEDema–angiotens in‐conversion enzyme inhibitor associations.Abstract:
Angioedema is a rare, potentially life-threatening condition that has been associated with angiotensin-converting enzyme inhibitors since their introduction in the 1980s. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), the largest antihypertensive study conducted to date, randomized 42,418 participants to a diuretic (chlorthalidone), a calcium channel blocker (amlodipine), an angiotensin-converting enzyme inhibitor (lisinopril), or an alpha-blocker (doxazosin). Patients who developed angioedema were compared for baseline characteristics and changes in antihypertensive drug administration. Fifty-three participants developed angioedema during active follow-up: 55% were black, 60% men, and 70% were assigned to lisinopril (including 62% of black participants with angioedema), 15% to chlorthalidone, 9% to doxazosin, and 6% to amlodipine. Six percent occurred within a day of randomization and 23% within the first week. Over half did not have an increase in their assigned (blinded) antihypertensive drug before angioedema onset; 3 (6%) had a dose increase within a week before onset. One patient died following an angioedema episode. The occurrence of angioedema in the angiotensin-converting enzyme inhibitor arm corresponds with previously reported angioedema-angiotensin-converting enzyme inhibitor associations.read more
Citations
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Propensity Score Methods for Confounding Control in Nonexperimental Research
TL;DR: Nonexperimental studies are increasingly used to investigate the safety and effectiveness of medical products as they are used in routine care, and confounding, systematic differences in prognosis between patients exposed to an intervention of interest and the selected comparator group is a primary challenge.
Journal ArticleDOI
Multicenter study of patients with angiotensin- converting enzyme inhibitor-induced angioedema who present to the emergency department
Aleena Banerji,Sunday Clark,Michelle Blanda,Frank LoVecchio,Brian D. Snyder,Carlos A. Camargo +5 more
TL;DR: ACEI-induced angioedema accounted for almost one-third of angIOedema treated in the ED, although it remains a rare ED presentation, and a subgroup of these patients still needs inpatient hospitalization for management of upper airway angioEDema.
Journal ArticleDOI
Comparative Risk for Angioedema Associated With the Use of Drugs That Target the Renin-Angiotensin-Aldosterone System
Sengwee Toh,Marsha E. Reichman,Monika Houstoun,Mary Ross Southworth,Xiao Ding,Adrian F. Hernandez,Mark Levenson,Lingling Li,Carolyn McCloskey,Azadeh Shoaibi,Eileen Wu,Gwen Zornberg,Sean Hennessy +12 more
TL;DR: Compared with β-blockers, ACEIs or aliskiren was associated with an approximately 3-fold higher risk for angioedema, although the number of exposed events for aliskirens was small.
Journal ArticleDOI
Risk of angioedema with angiotensin receptor blockers in patients with prior angioedema associated with angiotensin-converting enzyme inhibitors: a meta-analysis
TL;DR: The risk of angioedema was 9.4% (95% confidence interval, 1.6%-17%) for possible cases and 3.5% (0.0%-9.2%) for confirmed cases.
Journal ArticleDOI
Effectiveness, safety and cost of drug substitution in hypertension
TL;DR: T careful assessment of the human and economic costs and benefits of antihypertensive drug substitution is required before this practice is recommended.
References
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Journal ArticleDOI
Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT)
Curt D. Furberg,Jackson T. Wright,Barry R. Davis,Jeffrey A. Cutler,Michael H. Alderman,Henry R. Black,William C. Cushman,Richard H. Grimm,L. Julian Haywood,Frans H. H. Leenen,Suzanne Oparil,Jeffrey L. Probstfield,Paul K. Whelton,Chuke Nwachuku,David Gordon,Michael A. Proschan,Paula Einhom,Charles E. Ford,Linda B. Piller,I. Kay Dunn,David C. Goff,Sara L. Pressel,Judy Bettencourt,Barbara DeLeon,Lara M. Simpson,Joe Blanton,Therese S. Geraci,Sandra M. Walsh,Christine Nelson,Mahboob Rahman,Anne Juratovac,Robert Pospisil,Lillian Carroll,Sheila Sullivan,Jeanne Russo,Gail Barone,Rudy Christian,Sharon Feldman,Tracy Lucente,David A. Calhoun,Kim Jenkins,Peggy McDowell,Janice Johnson,Connie Kingry,Juan Alzate,Karen L. Margolis,Leslie Ann Holland-Klemme,Brenda Jaeger,Jeff D. Williamson,Gail T. Louis,Pamela Ragusa,Angela Williard,R. L Sue Ferguson,Joanna Tanner,John H. Eckfeldt,Richard S. Crow,John Pelosi +56 more
TL;DR: Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive and should be preferred for first-step antihypertensive therapy.
Journal Article
Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT)
TL;DR: The data indicate that compared with doxazosin, chlorthalidone reduces the risk of combined CVD events, particularly CHD death/nonfatal MI, in high-risk hypertensive patients.
Journal ArticleDOI
Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. A review of the literature and pathophysiology.
Zafar H Israili,W D Hall +1 more
TL;DR: A 4-day trial of withdrawal of the ACE inhibitor or temporary substitution of another class of antihypertensive agent inexpensively and easily ascertains if the ACE inhibitors caused the cough is easily ascertained.
Journal ArticleDOI
Rationale and Design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Barry R. Davis,Jeffrey A. Cutler,David Gordon,Curt D. Furberg,Jackson T. Wright,William C. Cushman,Richard H. Grimm,John C. LaRosa,Paul K. Whelton,H. Mitchell Perry,Michael H. Alderman,Charles E. Ford,Suzanne Oparil,Charles K. Francis,Michael A. Proschan,Sara L. Pressel,Henry R. Black,C. Morton Hawkins +17 more
TL;DR: The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a randomized, double-blind trial in 40,000 high-risk hypertensive patients, is designed to determine whether the combined incidence of fatal coronary heart disease (CHD) and nonfatal myocardial infarction differs between persons randomized to diuretic treatment and each of three alternative treatments.
Journal ArticleDOI
Omapatrilat and enalapril in patients with hypertension: The Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial
John B. Kostis,John B. Kostis,Milton Packer,Milton Packer,Henry R. Black,Henry R. Black,Roland Schmieder,Roland Schmieder,David Henry,David Henry,Elliott Levy,Elliott Levy +11 more
TL;DR: Omapatrilat provided broadly superior antihypertensive efficacy when used in a setting resembling clinical practice and the risk-benefit profile for omap atrilat in clinical use appears likely to be favorable in appropriate patients.