Blood pressure down, ankles swollen — why?
Amlodipine opens the arteries more than the veins, and the difference ends up in the ankles.
Select any card for the reasoning, what to watch for and an exam tip.
The puzzle
Amlodipine has brought this patient’s blood pressure down nicely. But by evening her ankles are puffy, and her shoes feel tight.
The answer, step by step
Who is most at risk
- Anyone on a dihydropyridine: amlodipine, felodipine, lacidipine, lercanidipine, nifedipine.
- Long spells of sitting or standing, when gravity pools the fluid.
What to do
Key takeaway
Dihydropyridines widen arterioles, so capillary pressure pushes fluid into the ankles — it isn’t salt and water retention, so diuretics only partly help.