Increasing hospitalizations due to angioedema in the United States

Abstract

Background: Angioedema may occur in patients taking angiotensin-converting enzyme inhibitors. With the more prevalent use of this class of medications in the United States, it is not known whether angioedema hospitalizations have increased nationally in recent years.

Objectives: To profile the trends in angioedema hospitalizations and to examine associated demographic factors and comorbid diseases in the United States.

Methods: A national database of hospitalizations in the United States was queried for hospitalizations with a principal diagnosis of angioedema and other major acute allergic disorders (anaphylaxis, urticaria, and allergy unspecified). Subsequent analysis was performed to determine the current angioedema hospitalization trends (1998-2005) and to examine clinical and demographic variables that distinguished angioedema from the other allergic disease admissions.

Results: The angioedema hospitalization rate was 3.3 in 100,000 in 1998 and rose to 4.0 in 100,000 in 2005. In contrast, the combined hospitalization rate for nonangioedema allergic disorders showed an overall decline and was exceeded by angioedema hospitalization rates after 2000. African American patients had consistently higher hospitalization rates (> or = 2 times) for angioedema compared with non-African American patients. Hypertension, increasing age, and African American ethnicity were associated with angioedema hospitalizations. Twenty-four percent of hospitalizations for angioedema were coded for an adverse effect due to cardiovascular or antihypertensive agents.

Conclusions: Angioedema has become the dominant allergic disorder that results in hospitalization in the United States. Angioedema hospitalizations have a distinct epidemiologic pattern that differs from that observed in other atopic disease hospitalizations.