Clinical Knowledge Question Results

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Question: A patient presents for follow-up after recently initiating a calcium channel blocker for hypertension. She reports good tolerance of the medication. She is normotensive on exam. Heart and lung exams are normal. She has mild lower extremity edema on exam, with no skin breakdown or ulcerations; the patient hardly noticed the mild edema and was not bothered by it. What is the most appropriate management?

14% of
Medical Professionals
Chose A

 

11% of
Medical Professionals
Chose B

 

48% of
Medical Professionals
Chose C

27% of
Medical Professionals
Chose D


Answer: C. Since the peripheral edema from calcium channel blockers is due to fluid redistribution rather than fluid overload, treatment with a diuretic is not indicated, and can lead to adverse outcomes such as acute kidney injury, electrolyte imbalance, falls, and incontinence, especially in older patients. Lowering the dose of the calcium channel blocker is not indicated for this patient who is tolerating the medication well, with good blood pressure control.  Lowering the dose or switching to another antihypertensive agent may be appropriate for patients who have discomfort or decreased mobility from their edema, or who have leg ulcerations.

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