Bleeding Disorders

Trigger-Happy: How to Reduce Stress for Fewer HAE Attacks

For those with hereditary angioedema, it sometimes feels like an attack can come out of nowhere. This rare genetic condition causes episodes of swelling, or edema, that can arise anywhere in the body. When swelling happens in the internal organs or the airway, HAE can become life-threatening.

HAEA has recorded a few common triggers for those with HAE. However, according to HAE Canada, there are no definitive or universal causes of HAE attacks, which makes the disease difficult to diagnose. Keeping a detailed journal of symptoms, attacks and any events and feelings that preceded the attack can help patients with narrowing down possible causes. This journal will help you and your doctor identify your personal triggers, so you can find ways to avoid them.

Let’s look at three types of stress—physiologic, physical and mental or emotional. Each one can lead to triggering HAE attacks.


First, you should know that physical stress is different from physiologic stress. Physical stress refers to the impact of an outside stressor on your body, while physiologic stress involves the mechanics of your body: namely, the way your body processes work.

Of the sources of physiologic stress, sickness is the most easily identifiable trigger. Bacterial and viral infections can trigger HAE attacks, according to HAE Hope. That means that something as simple as the onset of a summer cold may indicate that an attack is coming.

In addition, women are more likely to show HAE symptoms than men. A 2010 article described the hormonal factors that play a significant role in triggering HAE attacks in women. This means that if you are a woman with HAE, the use of hormone replacement therapy or combined contraceptive pills (those containing both estrogen and progesterone) may be harmful to you.


Physical stressors include injuries, surgeries, and even dental procedures. Even minor trauma, such as stress injuries associated with typing, gardening and other physical activities, may trigger HAE attacks. notes that surgery and dental procedures can also trigger HAE attacks. Dental procedures are a particularly important consideration, as swelling in the airway poses a risk of asphyxiation. Always talk with your doctor or HAE specialist before scheduling any surgery or dental procedure, as you may receive short-term prophylaxis (pre-treatment) to counteract an attack.

Finally, if possible, avoid taking ACE inhibitors, as these heart-disease medications can trigger HAE attacks. Consult your doctor if you’re unsure about whether the medications you’re taking are putting you at risk for HAE attacks.

Mental and Emotional

Patients in this 2014 article kept a detailed journal of their attacks, including date and time of onset, location, severity and potential trigger factors. During the initial stage, 21 percent of patients described mental stress as their most common HAE trigger.

While we should all take steps to reduce stress, it’s especially crucial for HAE patients to lower the amount of stress they experience on a daily basis. Resolving conflicts at work and at home can help decrease the amount of anxiety or stress you live with. Don’t rise to the bait if someone starts an argument with you, and try to avoid high-tension situations.

When you do feel stressed, ask friends and family to lend an ear. Sharing feelings and worries with those close to you can help decrease anxiety, according to the American Psychological Association. Meditation or mindful prayer, exercise and taking a break from whatever is stressing you out can also offer much-needed relief.

Experiment with recording HAE attacks and the events or feelings that surround them. You may gain insight into your own personal triggers—and that knowledge could be the first step toward reducing the frequency and severity of your attacks.

The information herein may not be construed as medical advice. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. It should not be used as a substitute for professional diagnosis and treatment. It is best to obtain medical recommendations from your physician.