Some antihypertensives can have the effect of malleolar edema because they reduce blood pressure but increase intercapillary pressure and the leakage of fluids from the capillary bed. A phenomenon amplified by the heat
I am a 67 year old man and, suffering from hypertension, my doctor (now deceased) had prescribed me a permanent therapy: nebivolol, ramipril, acetylsalicylic acid 100 mg, amlodipine of 5mg, distributed throughout the day. I now have constant swelling in my ankles that extends to my toes. They tell me the cause due to amlodipine: what can I do? What other medicine could I replace this medicine with?
He answers Anne the Apostleassistant contact person for the Heart Failure Operational Unit, Clinical and Rehabilitative Cardiology, Monzino IRCCS Cardiology Center in Milan (GO TO THE FORUM)
L’amlodipine a drug that belongs to the class of calcium channel blockers. These drugs work by interfering with the movement of calcium ions into cells by relaxing vascular smooth muscle. L’effect that of dilatation of the coronary and peripheral vesselsreducing the pressure values but increasing the intercapillary pressure and the leakage of fluids from the capillary bed: this is why malleolar oedemas appear.
This phenomenon amplified in the summer months where is there one greater vasodilation due to the high temperatures.
L’dose dependent effectso to reduce or eliminate this problem, it is sometimes sufficient to halve the dose of amlodipine, possibly associating a small dose of diuretic to the ramipril you are taking.
I don’t know if it has performed recently blood tests which should still be checked to rule out other pathologies as the cause of edema that you complain; I would suggest monitoring, in addition to routine blood tests (including renal function and plasma electrolytes), the examination of the dosage of thyroid function (TSH reflex) and BNP (type B natriuretic peptide).
Nonetheless, I recommend rely on a doctor who can replace
The his previous personal physician.
August 20, 2023 (change August 20, 2023 | 08:06)
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