DHP CCB-Induced Peripheral Edema
Personally, I like using dihydropyridine calcium channel blockers (DHP CCB) in my clinic when managing blood pressure (given no comorbid disease states). Why? Because it's the only first-line agent that's easy to titrate and doesn't require lab follow-up, which is a HUGE plus especially for those who have difficulty getting to the lab. However, the main caveat of using a DHP CCB is the famous peripheral edema, more specifically, bilateral ankle swellings. In pharmacy school, we learned that DHP CCB can cause dose-dependent peripheral edema in addition to constipation and, rarely, gingival hyperplasia (ya'll remember that?). But did you guys know that the risk of CCB-induced peripheral edema may be reduced if used with ACEs/ARBs? If you did, kudos to you. This is news to me and it blew my mind so I'm going to share it here :) (slide credit: Dr. Aziz-ur-Rehman) As seen above, the mechanism of action of peripheral edema is thought to be due to CCB's action