A 64 year old male patient was struggling with blood pressure management, usually running in the 160’s range (systolic). He was already taking lisinopril 40 mg daily and had failed at implementing lifestyle changes up to this point. Procardia (nifedipine extended release) 30 mg daily was added to this patient’s regimen. It had minimal effect and the patient was slowly titrated up to a dose of 120 mg daily. This had dropped the blood pressure 10-20 points on average, but the patient refused to continue to take the medication due to bothersome significant edema. This patient was successfully transitioned to a beta-blocker as well as a low dose thiazide diuretic for blood pressure management. Calcium channel blockers are effective at lowering blood pressure, but are also one of the more common medication causes of edema especially at higher doses.
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