Key result
Higher amlodipine doses linked to ~3-fold higher odds of peripheral edema in hypertension.
Why the study?
Amlodipine commonly causes peripheral edema leading to drug discontinuation, prompting an investigation into its prevalence, risk factors, and management among hypertensive adults in a Thai primary care unit.
What is the prevalence, associated risk factors, and clinical management of amlodipine-related peripheral edema in adult hypertensive patients attending a primary care unit in Thailand?
Cross-Sectional (n=572)
No
What is the prevalence, associated risk factors, and clinical management of amlodipine-related peripheral edema in adult hypertensive patients attending a primary care unit in Thailand?
In a Thai primary care setting, amlodipine-induced peripheral edema occurred in 11.9% of hypertensive patients—predominantly at the 10 mg dose—and led to switching to alternative dihydropyridine calcium channel blockers (manidipine or lercanidipine) or other antihypertensive classes in nearly all affected patients.
Identifies diabetes and high-dose amlodipine as edema risk factors; hypothesis-generating for dose optimization in primary care.
Backgound: Amlodipine, a dihydropyridine calcium channel blocker, is used to treat hypertension. The common adverse drug reaction of amlodipine was peripheral edema. This causes the discontinuation of amlodipine. Objective: The primary objective of this study was to investigate the prevalence of amlodipine related peripheral edema in hypertensive adults attending a primary care unit in Thailand. The secondary objectives were to evaluate risk factors and how the edema was managed. Methods: A retrospective, cross-sectional study was conducted from January 2019 - December 2023 in a primary care unit in Thailand. Hypertensive patients on amlodipine 2.5, 5 and 10 mg were recruited. Clinical characteristics of edema, comorbidity and management of edema were collected from the electronic medical records and drug-use evaluation forms. Data were analysed by descriptive statistics. Logistic regression analysis [adjusted odds ratios (aOR)] explored variables associated with peripheral edema. Results: A total of 572 patient records were eligible for an edema prevalence of 11.9%. Median duration of edema was 84 days. Clinically, edema was bilateral in almost all patients, affecting mostly the leg (51.47%). Diabetes mellitus was identified as an independent risk factor for edema [adjusted odds ratio (aOR) 2.690; 95% CI 1.176–6.152]. In contrast, dyspepsia [aOR 0.263; 95% CI 0.091–0.754] and lower doses of amlodipine (2.5 and 5 mg) were associated with a reduced risk of edema compared with the 10-mg dose; the aOR for the 2.5-mg dose was <0.001, indicating complete separation, while the aOR for the 5-mg dose was 0.329 (95% CI 0.161–0.673). The most frequent management strategy was stopping amlodipine and prescribing lercanidipine or manidipine (57.35%). Conclusion: This study showed a high prevalence of amlodipine-related to edema in primary care unit in Thailand, resulting in a change of treatment in most patients. Patients receiving high doses of amlodipine or those with diabetes should be closely monitored for peripheral edema. Further studies are required to explain the molecular mechanisms underlying edema from amlodipine.
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Chaikan et al. (2026) conducted a cross-sectional in Essential hypertension (n=572). Amlodipine vs. Lower amlodipine doses (2.5 mg or 5 mg) was evaluated on Amlodipine-related peripheral edema (OR 2.98, 95% CI 1.50-5.93, p=0.002). Amlodipine was associated with an 11.9% prevalence of peripheral edema in hypertensive primary care patients, with higher doses increasing edema odds (aOR 2.98, 95% CI 1.50–5.93, p=0.002).
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