Adverse drug reactions of angiotensin converting enzyme inhibitors: towards precision medicine

Abstract

Worldwide, millions of patients with cardiovascular diseases are treated with angiotensin converting enzyme inhibitors (ACEIs) according to the international treatment guidelines. Although this class of medications is generally well tolerated, adverse drug reactions (ADRs) may prevent their use in some individuals. The most common side effect is a persistent cough that may require cessation of ACEI use. ACEIs can also cause angioedema, which is rare but extremely dangerous and can even be life-threatening because it occurs mainly at mouth, lips and upper airways. This ADR can be fatal within a few hours. Hundred thousands of hospitalizations will be preventable if that would be possible to predict these ADRs before starting the ACEIs, additionally patients will consume their medication more precisely according to the physician’s order if they do not develop ADRs which will result in more successful treatment of cardiovascular disease. Results from this thesis showed that there are some non-genetic factors associated with ACEI-induced ADRs for example having the history of asthma or allergic disease. Additionally we introduced some genetic markers associated with ACEI-induced ADRs. If these results will be replicated in other studies, they can be a suitable predictors for ACEI-induced ADRs.