HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Edema When Suffering From Hypertension?

Posted on Tue, 23 Sep 2014

Question: Hi. I am a 67 year-old male with hypertension. I've been on Bystolic exclusively for about two months. Before, I was taking Amlodipine alone, and then with Bystolic together (in all cases [combined and uncombined] for a 5mg total). I had a blood test two weeks ago and passed with flying colors. But suddenly I have developed pitting endema (spelling?) in one calf that lasted about 10 days; but just when it seemed to be getting better, it migrated down to the foot, where it is quite painful. I can't get to my doctor for another two days. In the mean time, I have cut out alcohol (I'm a light drinker anyway), caffeine (only 1-2 cups of coffee per day), and what little salty foods I do eat (I am not especially salt-sensitive). I am wondering, should I drop the Bystolic and go back to Amlodipine for the next two days?

Answered by Dr. Danish Sheikh (2 hours later)

Brief Answer:
keep continuing same drugs

Detailed Answer:
Hi,
I have gone through your history in detail and will help you in best possible way,

Firstly in my opinion you should not shift to amlodepine because some patient report periferal oedema with use of amlodepine. Edema with bystolic is comparatively very less when compared with that of amlodepine associated edema.
Keep continuing your current medicine,

Secondly to change the drug regular monitoring of blood pressure and adjustment of doses will be required,

Regarding oedema,
I appreciate,your efforts like salt restriction,

To help in you in better way I will like to know some history,

Are you getting swelling in only one leg??
Do you get pain in leg while walking and standing??
How is your urine output compared to earlier??
Have your recently undergone any surgery??
Do you get breathlessness??
How is the colour of skin over affected calf and foot???

Awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Danish Sheikh (2 hours later)

The swelling is only in in one leg, The pain comes from walking, standing, or even centrifugal force from just swinging the leg about. Urination is completely normal. I've had no surgeries in a long while. I exercise vigorously, so breath is not a problem. The skin color is a very slight red, almost imperceptible, and the leg feels warm.

Answered by Dr. Danish Sheikh (5 hours later)

Brief Answer:
propably can be DVT or lymphodema

Detailed Answer:
Hi,
Thanks, For giving history in details,

Your having unilateral pain and swelling,
What comes to my mind is deep vein thrombosis or lymphodema,
Cardiac and renal cause is unlikely,

To confirm and know the certain thing you will have to undergo,some investigation like,
colour Doppler scan of leg,
Sr.creatinine and Sr.urea,
Complete blood count,
LFT,

And detailed physical examination is needed,
It needs immediate attention,

Visit your physician as soon as possible get your investigation and physical examination done,

Hope this information helps.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari