Quality of Life and Antihypertensive Drug Therapy

Joel Handler, MD

In This Article

Calcium Channel Blockers

Edema is the main side effect of this group of agents. It differs between the agents. About 5% of patients on nondihydropyridine CCBs, such as verapamil and diltiazem, will experience CCB-related edema compared with 10%-25% receiving a dihydropyridine CCB.[40] If edema occurs with one of these agents and is annoying, lower the dosage since it is a dose-related side effect, or switch to a different CCB or antihypertensive agent. Additionally, using an ACE inhibitor together with a CCB may lessen CCB-related edema via ACE-related efferent arteriolar vaso-and venodilatation, which counterbalances the afferent arteriolar CCB vasodilatation effect, thereby lowering "hypertension" across the capillary circuit.[41] It is important to realize that because of the physiology, diuretic therapy does not ameliorate CCB edema because it is not a state of fluid overload. CCBs are, themselves, natriuretic agents.[41]