Calcium channel blocker-related peripheral edema developed in 38.7% of hypertensive Ethiopian patients, with longer daily standing duration as the only independent risk factor and higher amlodipine doses associated with greater and earlier edema onset.
Key Findings
Results
Peripheral edema developed in 38.7% of hypertensive patients prescribed calcium channel blockers, with a mean onset time of 8.3 weeks.
Study population consisted of 292 participants with a mean age of 58.2 years, 53.4% female.
20.9% of participants had diabetes mellitus and 16.8% had dyslipidemia as comorbidities.
Amlodipine was the most frequently prescribed CCB, accounting for 94.8% of prescriptions.
Time-to-event analysis showed a progressive increase in edema risk with continued CCB use.
Data were collected between July 15 and August 14, 2025 via interviews and medical record reviews using systematic random sampling.
Results
Longer daily standing duration was the only factor independently and significantly associated with CCB-related peripheral edema in multivariate logistic regression analysis.
Adjusted odds ratio (AOR) for longer daily standing duration = 1.92 (95% CI: 1.03–3.58; p = 0.041).
Binary and multivariate logistic regression analyses were used to identify associated factors.
A p-value < 0.05 was considered statistically significant.
Other sociodemographic and clinical variables tested were not independently significant in the multivariate model.
Results
Patients receiving amlodipine 10 mg daily had a greater incidence and earlier onset of peripheral edema compared to those on amlodipine 5 mg daily.
Edema incidence was 42.5% in patients on amlodipine 10 mg daily versus 33% in those on amlodipine 5 mg daily.
The difference in time to edema onset between the two dose groups was statistically significant (log-rank p = 0.003).
Amlodipine was the predominant CCB prescribed, used by 94.8% of participants.
Time-to-event analysis was used to assess duration from CCB initiation to edema onset.
Discussion
CCB-related peripheral edema is a common vasodilatory adverse effect that may lead to unnecessary investigations or treatments such as diuretics if not recognized.
The authors note that CCBs are commonly prescribed for hypertension because they are effective and affordable.
Peripheral edema from CCBs may lead to additional therapy and affect medication adherence.
The authors recommend clinicians be aware of the high prevalence to provide effective patient counseling.
The study context is Ethiopian hypertensive patients managed at multiple centers.
Methods
This was a retrospective multicenter cohort study of adults with essential hypertension prescribed CCBs in Ethiopia, using systematic random sampling.
A total of 292 participants were selected using systematic random sampling.
Eligibility required adults aged ≥18 years with essential hypertension prescribed CCBs.
Data collection used a structured questionnaire covering sociodemographic and clinical variables combined with medical record reviews.
Descriptive statistics summarized baseline characteristics, and the log-rank test assessed time to edema onset.