Comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on ankle volume and subcutaneous interstitial pressure in hypertensive patients: A double-blind, randomized, parallel-group study

Background: Ankle edema is one of the most common side effects of antihypertensive treatment with calcium channel blockers (CCBs). The incidence of edema is higher with dihydropyridines than with verapamil or diltiazem. Objective: The aim of this study was to compare the effect of antihypertensive treatment with the new CCB lercanidipine versus nifedipine gastrointestinal therapeutic system (GITS) on ankle-foot volume (AFV) and on pretibial subcutaneous tissue pressure (PSTP), considered objective measures of CCB-induced ankle edema. Methods: Patients with mild to moderate hypertension (diastolic >90 mm Hg and 2O) compared with nifedipine GITS (AFV, 284.2 mL; PSTP, 1.8 cm H₂O). In both treatment groups, correlation analysis showed an inverse relationship, although to a different degree, between AFV and PSTP changes, but not between absolute values of AFV and PSTP during treatment. AFV increase was greater and PSTP increase was lower with increasing age, which suggests a role for age in the type of tissue response to a stimulus for edema formation. No relationship was found between AFV and PSTP changes and BP reduction. Conclusions: These data suggest that lercanidipine produces significantly less increases in AFV and PSTP, 2 objective measures of edema formation, than nifedipine GITS.