Calcium Channel Blockers and Edema

Healthcare experts around the world prescribe calcium channel blockers to treat several health conditions, including migraine headaches, high blood pressure, circulatory issues, and complications of brain aneurysms. 

Calcium channel blockers, come in many forms, including short-acting medications and long-acting medications. Verapamil, diltiazem, and nifedipine are among the calcium channel blockers listed by MedlinePlus. 

The common side effects of calcium channel blockers include peripheral edema or swelling of the legs, feet, and ankles from the accumulation of fluid. 

According to Mayo Clinic, calcium channel blockers are medications that prevent calcium from entering into the muscle cells in the heart and around the blood vessels. 

Muscle cells require calcium to contract, so the main purpose of calcium channel blockers is to make it difficult for the muscle cells in the heart and blood vessels to contract. This causes your heart to beat with less energy and your blood vessels to expand, thus lowering blood pressure. 

According to a study published in the ‘Journal of Clinical Hypertension’ in 2003, calcium channel blockers may cause edema due to their effects on the blood pressure in different blood vessels. 

These medications cause blood pressure in arteries to fall, but the pressure in the veins remains the same. This creates a pressure difference in the capillaries. This imbalance pushes fluid out of the blood and into the space between cells, resulting in edema. 

What Causes Edema: 

While all CCBs inhibit the L-type calcium channel on cells, they are divided into two main categories depending on their predominant physiologic effects: the dihydropyridines, which are mostly vasodilator and usually have neutral or increased effects on vascular permeability; and the non-dihydropyridines (verapamil and diltiazem), which decrease vascular permeability and affect cardiac contractility.

In placebo-controlled studies, the rate of edema was 11% in a group administered with nifedipine, 14% in a group administered with felodipine, and 2% to 20% in the placebo groups.

The non-dihydropyridines are also known to promote leg and ankle swelling. Verapamil increases plasma volume, and it nullifies postural cutaneous vasoconstriction in the lower extremities.

One placebo-controlled study found that the occurrence of edema in patients with hypertension who were treated with verapamil was 3% compared with 5% in the placebo group. Other non-placebo-controlled studies have found a 1% to 14% frequency of edema in patients administered with verapamil.

Treatment for Edema: 

The most effective way of treating edema associated with calcium channel blockers is to change the medication being used. As per the Journal of Clinical Hypertension, some calcium channel blockers are less likely to cause peripheral edema. 

Another treatment option is to take a medication that dilates the veins. This aids in relieving the pressure imbalance, and preventing edema. Always consult your doctor before starting, discontinuing, or changing the dose of any medication. 

Patients suffering from edema should avoid sitting or standing in the same position for extended periods of time, as this can worsen edema. You may perform leg exercises to move fluid back towards your heart, and wear support socks if necessary. 

MayoClinic also recommends massage therapy and acupuncture to reduce the swelling. You may also consider taking Capisette, an effective natural fluid retention remedy containing powerful ingredients.