Recommendations of the European and American societies of cardiologists have referred calcium channel blockers to the main groups of medicines that prescribe patients with arterial hypertension and this is very true. But not all that is important to know about the clinical use of these medicines is written in them, and I want to make a few emphases.
Calcium channel blockers comparably reduce systolic and diastolic blood pressure and therefore there is a need to be cautious in patients with isolated systolic hypertension and hypertension with low pulse pressure or, in other words, diastolic hypertension. In the first case, efforts may result in the development of orthostatic arterial hypotension with unfortunate consequences and in the second case, illness can gain due to a further decrease in pulse pressure by reason of the predominant decrease in systolic over diastolic pressure. Recommendations draw attention to the problem of using calcium channel blockers in arterial hypertension’ patients with heart failure, and this is true. It must be remembered that the edematous feet are visualized when the volume of the tissue fluid exceeds the physiological level at least twice, and here one must be very careful not to miss, or rather, to prevent the development of edema as a complication of long-term administration of amlodipine. I want to remind you that in addition to the racemic, there is a levorotatory amlodipine, the named complication of which appears much later. I would also like to especially note that the appearance of these complications occurs in the so-called slow metabolizers, and therefore the timely reduction of doses, as well as the more rare use of the medication, can significantly delay, if not prevent the appearance of edema. If you liked the video, click on the button below and subscribe to the channel. Thank you for the attention. M. Iabluchanskyi
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