Avoiding disease triggers

Sometimes, angioedema attacks are triggered by certain factors. In these cases, patients can attempt to avoid, or, at least, limit, these triggers. Patients with  histamine-mediated angioedema can obtain further information here.

Trigger Solution
Stress Stress management training such as autogenic training
Diet Avoid specific food or components
Medication Seek alternatives
Heat/cold Choose vacation destinations accordingly
Prolonged sitting or standing Change position frequently, if possible

In most cases, however, attacks develop without an identifiable trigger and without warning. In addition, it is often neither sensible nor even feasible to avoid all potential triggers since this would represent an unnecessary limitation of the patient’s quality of life. This issue must be addressed individually under consideration of the patient’s frequency and severity of HAE attacks.

Things to consider regarding use of medication

There are several medications that can increase the severity of bradykinin-mediated angioedema. For example, oestrogen-containing preparations, such as oral contraceptives or hormone replacement therapy for post-menopausal women may be problematic because they may lead to an increased frequency of attacks. Contraceptives that contain progesterone may be a suitable alternative for some of these women.

ACE inhibitors and AT-1 blockers can aggravate the clinical picture. Other anti-hypertensive medication should be preferred for treating high blood pressure in patients with angioedema.