Colleges of Pharmacy and Internal Medicine, University of Florida, Gainesville, FL, USA.
Am J Ther. 2009 Nov-Dec;16(6):543-53. doi: 10.1097/MJT.0b013e3181afbf9f.
Calcium channel blockers (CCBs) play a vital role in the management of hypertension. Peripheral edema is the most common side effect reported with CCB monotherapy, especially with high-dose dihydropyridine CCBs. CCB-related peripheral edema is a dose-limiting effect that is usually medically benign but can compromise patient adherence. CCB-related peripheral edema may cause considerable discomfort and patient concern. Patients presenting with peripheral edema should undergo assessment for drug and nondrug causes. Rather than lowering the CCB dose or switching to another monotherapy, combination therapy (e.g, CCB plus a renin-angiotensin-aldosterone system inhibitor) can enhance blood pressure control, generally with lower doses of individual agents, and lessen the risk of adverse events. As recommended by consensus guidelines, addition of a renin-angiotensin-aldosterone system inhibitor as part of combination therapy may accelerate the time to goal blood pressure as well as help alleviate peripheral edema in affected patients. Successful management of CCB-related peripheral edema with lifestyle changes and rational combination therapy is likely to improve blood pressure control and patient outcomes.
钙通道阻滞剂（CCB）在高血压治疗中起着至关重要的作用。与 CCB 单药治疗相关的外周水肿是最常见的副作用，尤其是与高剂量二氢吡啶类 CCB 相关。CCB 相关的外周水肿是一种剂量限制效应，通常对机体无害，但会影响患者的顺应性。CCB 相关的外周水肿可能会引起相当大的不适和患者的担忧。出现外周水肿的患者应评估药物和非药物原因。与降低 CCB 剂量或改用其他单药治疗不同，联合治疗（例如，CCB 加肾素-血管紧张素-醛固酮系统抑制剂）可以增强血压控制，通常使用较低剂量的单一药物，降低不良事件的风险。根据共识指南的建议，将肾素-血管紧张素-醛固酮系统抑制剂作为联合治疗的一部分，可以加速达到目标血压的时间，并有助于缓解受影响患者的外周水肿。通过生活方式改变和合理的联合治疗成功管理 CCB 相关的外周水肿，可能会改善血压控制和患者预后。
