Calcium channel blockers induced pedal edema; mechanism and treatment options: Review

Shetty, Kiran Kumar and Shetty, Ranjan K and Ganiga, Naveen Chandra S and Reddy, Rohit P and Nayak, Vidhya (2015) Calcium channel blockers induced pedal edema; mechanism and treatment options: Review. International Journal of Sciences & Applied Research, 2 (12). pp. 27-33.

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Abstract

Hypertension is one of the most common clinical conditions encountered by the physicians. There are wide ranges of medications available for treatment of hypertension, in which Calcium Channel Blockers (CCBs) are the one of the most commonly prescribing drug. The first generation antihypertensive drug nifedipine was introduced in 1960s; due to its rapid vasodilatory action it enhances the sympathetic tone. The second and the third generation drugs showed the reduction of sympathetic reflex by its slow-releasing action. Amlodipine which was introduced as the third generation, exhibits longer half-life and most potent antihypertensive agent as compared to the previous generation agents. Ankle edema is one of the most frequent adverse effects of amlodipine often leading to noncompliance and discontinuation of an effective antihypertensive drug. Cilnidipine is a fourth generation calcium channel blocker with unique features, which inhibits both sympathetic N-type and vascular L-type Ca2+ channels. Interestingly, Cilnidipine shows complete resolution of amlodipine induced pedal edema in clinical practice. Therefore, this strategy may provide a new approach for the treatment of cardiovascular diseases. This review article is aiming to explain the calcium channel blocker - associated edema and resolution of edema through the use of L and N-type of calcium channel blockers. CCBs are potential antihypertensive agents but the main drawback of this group of drug is it produces pedal edema which decreases the compliance. The main cause for CCB-induced edema increased capillary hydrostatic pressure by arteriolar dilation. The new L and N-type of CCB cause pre and post capillary dilatation which normalizes the hydrostatic pressure, which resolves the edema.

Item Type: Article
Uncontrolled Keywords: Pedal edema; Amlodipine; Cilnidipine; Calcium Channel Blockers.
Subjects: Allied Health > MCOAHS Manipal > Cardiology
Medicine > KMC Manipal > Cardiology
Depositing User: KMC Library
Date Deposited: 22 Dec 2015 16:24
Last Modified: 22 Dec 2015 16:24
URI: http://eprints.manipal.edu/id/eprint/144918

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