EVALUATION OF CAUSATIVE FACTORS IN AMLODIPINE INDUCED PEDAL EDEMA
Keywords:Calcium channel blocker, Amlodipine, Pedal edema, Causative factors
Objective: To study the edema causing factors in hypertensive, amlodipine-induced pedal edema patients.
Methods: The present was a prospective, observational study. A total of one hundred and twenty-four essential hypertensive patients, of either gender attending the outpatient department of cardiology and medicine, were recruited for this study. Out of the 124 patients, 62 were of the amlodipine-induced pedal edema [AIPE] group and other 62 patients were amlodipine-treated non-edema [ATNE] group. All the patients were receiving a dosage of amlodipine 5 mg/day. All recruited patients completed the study. The present study conducted at Kasturba Hospital, Manipal.
Results: The vanillyl mandelic acid (VMA) (meanÂ±SD) 7.08Â±2.3 mg/24 h and 4.9Â±1.7 mg/24 h in AIPE and ATNE groups respectively. Blood pressure (BP) and VMA was higher in AIPE group than the ATNE group (p<0.001). Pulse rate (PR), serum proteins, creatinine, sodium, osmolality, did not show any significant difference between the two study groups.
Conclusion: In essential hypertensive patients with AIPE group presented with a higher VMA level than the ATNE group. The elevated catecholamine's possibly the causative factor for AIPE.
Tripathi P, Venkataraman R, Bp SK, Kumaraswamy M, Singh R, Pandey M, et al. Lifestyle factors: an alarm towards hypertension. Asian J Pharm Clin Res 2013;6:185-8.
Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. hypertension in India: a systematic review and metaâ€‘analysis of prevalence, awareness, and control of hypertension. J Hypertens 2014;32:1170â€‘7.
Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment. Vasc Health Risk Manage 2008;4:23â€‘30.
Schiffrin EL, Lipman ML, Mann JF. Chronic kidney disease: effects on the cardiovascular system. Circulation 2007;116:85â€‘97.
Owen AJ, Reid CM. Cardio classics revisited: focus on the role of amlodipine. Integr Blood Pressure Control 2012;5:1â€‘7.
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. Evidence-based guideline for the management of high blood pressure in adults: a report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507-20.
Adake P, Somashekar HS, Mohammed Rafeeq PK, Umar D, Basheer B, Baroudi K. Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: a prospective study. J Adv Pharm Technol Res 2015;6:81-5.
Shetty R, Vivek G, Naha K, Tumkur A, Raj A, Bairy KL. Excellent tolerance to cilnidipine in hypertensives with amlodipine-induced edema. North Am J Med Sci 2013;5:47-50.
Weir MR. The incidence of pedal edema formation with dihydropyridine calcium channel blockers: issues and practical significance. J Clin Hypertens 2002;5:330-5.
Sica DA. Calcium channel blocker-related peripheral edema: can it be resolved? J Clin Hypertens 2003;5:291â€“5.
Weir MR. The incidence of pedal edema formation with dihydropyridine calcium channel blockers: issues and practical significance. J Clin Hypertens 2003;5:330â€‘5.
Oike M, Inoue Y, Kitamura K, Kuriyama H. Dual action of FRC8653, a novel dihydropyridine derivative, on the Ba2+current recorded from the rabbit basilar artery. Circ Res 1990;67:993â€“1006.
Maheshwari P. A comparative study to evaluate the efficacy of amlodipine with bisoprolol in hypertensive patients. Asian J Pharm Clin Res 2014;7:98-102.
Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the national health and nutrition examination survey i epidemiologic follow-up study. Arch Family Med 1997;6:43-9.
Pan Y, Cai W, Cheng Q, Dong W, An T, Yan J. Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies. Neuropsychiatr Dis Treat 2014;11:1121-30.
Player MS, Peterson LE. Anxiety disorders, hypertension, and cardiovascular risk: a review. Int J Psychiatry Med 2011;41:365-77.
Pedrinelli R, Dellâ€™Omo G, Mariani M. Calcium channel blockers, postural vasoconstriction and dependent edema in essential hypertension. J Hum Hypertens 2001;15:455â€“61.
Messing M, Van Essen H, Smith TL, Smits JF, S Boudier HA. Microvascular actions of calcium channel antagonists. Eur J Pharmacol 1991;198:189â€‘95.
De Champlain J, Karas M, Nguven P. Different effect of nifedipine and amlodipine on circulatory catecholamine level in essential hypertensive patients. J Hypertens 1998;16:1357-69.
Milovanovic B, Trifunovic D, Milicevic N, Vasic K, Krotin M. The significance of amlodipine on autonomic nervous system adjustment (ANSA Method): a new approach in the treatment of hypertension. Srp Arh Celok Lek 2009;137:371-8.
Graeme Eisenhofer, Irwin J Kopin, David S Goldstein. catecholamine metabolism: a contemporary view with implications for physiology and medicine. Pharmacol Rev 2004;56:331-49.
Rassler B. Contribution of Î±-and Î²-adrenergic mechanisms to the development of pulmonary edema. Scientifica 2012:1-11. Doi:10.6064/2012/829504.