Lisinopril is a commonly prescribed medication for managing high blood pressure and various heart conditions. It belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. Lisinopril can sometimes lead to swelling as a side effect. Understanding the types of swelling and their causes is important for individuals taking this medication.
Lisinopril and Swelling
Lisinopril works by blocking the angiotensin-converting enzyme, which plays a role in regulating blood pressure. This action prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Consequently, blood vessels relax and widen, reducing blood pressure and making it easier for the heart to pump blood.
An additional effect of ACE inhibition is the increased presence of a substance called bradykinin. The enzyme blocked by lisinopril is also responsible for breaking down bradykinin in the body. When this breakdown is inhibited, bradykinin levels can accumulate.
Elevated bradykinin can increase the permeability of blood vessels, allowing fluid to leak into surrounding tissues. This fluid accumulation can manifest as swelling, often in areas like the ankles, feet, or hands, a condition known as peripheral edema. Not everyone taking lisinopril will develop this side effect.
Understanding Angioedema
A more serious, though rare, form of swelling associated with lisinopril is angioedema. Angioedema involves sudden, significant swelling that occurs beneath the skin or mucous membranes. Unlike superficial hives, angioedema affects deeper layers of tissue and typically does not cause itching.
Common areas affected by angioedema include the face, lips, tongue, throat, and eyelids. Swelling in the throat or tongue can be particularly concerning as it may lead to difficulty breathing or swallowing, posing a life-threatening risk due to potential airway obstruction. Other symptoms can include hoarseness or even abdominal pain if the swelling affects the gastrointestinal tract.
Angioedema caused by ACE inhibitors like lisinopril is a bradykinin-mediated response, due to the accumulation of bradykinin rather than a typical allergic reaction. Traditional allergy treatments like antihistamines and corticosteroids may not be effective in these cases. Though angioedema can resemble an allergic reaction, it is a distinct condition requiring prompt medical evaluation.
Managing Swelling and When to Seek Help
For individuals experiencing mild swelling, such as peripheral edema in the ankles or feet, it is advisable to discuss these symptoms with a healthcare provider during a regular appointment. The doctor can assess the situation and consider potential adjustments to the medication dosage or explore other management strategies. It is also important to consider other possible causes of leg swelling, such as underlying heart or kidney conditions.
However, if swelling appears suddenly, is severe, or affects the face, lips, tongue, or throat, immediate emergency medical attention is necessary. These symptoms could indicate angioedema, which can rapidly progress and compromise the airway. Individuals should call emergency services or go to the nearest emergency room without delay.
Individuals should never stop taking lisinopril or any prescribed medication without first consulting their doctor. Abruptly discontinuing lisinopril can lead to a sudden increase in blood pressure, known as rebound hypertension, posing serious health risks. A healthcare provider can safely guide any necessary changes to medication.