Which adverse effect is particularly associated with ACE inhibitors and may occur with ARBs and requires monitoring?

• A. Hyperkalemia
• B. Angioedema
• C. Hypotension
• D. Renal function impairment

Answer: (B)

Angioedema is the adverse effect most closely linked to ACE inhibitors. Blocking the enzyme that degrades bradykinin leads to its buildup, causing swelling from the face to the airway in some patients. This reaction is not the same as the usual dose‑related effects like low blood pressure or kidney function changes, and it can be life‑threatening if airway swelling progresses, so it requires careful monitoring and prompt management, including ensuring airway safety. ARBs can cause angioedema too, but much less commonly, since they don’t raise bradykinin levels as ACE inhibitors do. Other common concerns with these drugs—like hyperkalemia, hypotension, or renal function impairment—are monitored routinely, but they don’t carry the same high‑stakes, bradykinin‑mediated risk as angioedema.