HAE Attack Triggers

What causes Hereditary Angiodema (HAE) attacks?

Most attacks occur spontaneously, with no apparent reason; however anxiety, stress, minor trauma, surgery, and illnesses such as colds and flu have been cited as triggers. Trauma to the oral cavity caused by dental procedures make HAE patients particularly vulnerable to airway attacks. Patients have also reported swelling in extremities following typing, prolonged writing, pushing a lawn mower, hammering, shoveling, and other physical activities.

In women, menstruation and pregnancy seem to have a major effect on disease activity. Some women patients report a definite increase in the number of attacks during their menstrual periods. During pregnancy, some patients note an increase in the frequency of attacks, while others have reported a decrease. Use of oral contraceptives and hormone replacement therapy is associated with an increase in the frequency and severity of attacks.

ACE Inhibitors have been known to increase the frequency and intensity of HAE attacks. ACE Inhibitors are often prescribed to treat high blood pressure. Below is a list of some of the ACE Inhibitors licensed in the US:

• captopril (Capoten)
• benazepril (Lotensin)
• enalapril (Vasotec)
• lisinopril (Prinivil, Zestril)
• fosinopril (Monopril)
• ramipril (Altace)
• perindopril (Aceon)
• quinapril (Accupril)
• moexipril (Univasc)
• trandolapril (Mavik)