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Hypertension first-line therapy — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHypertension first-line therapyGPhC CRA

A 63-year-old woman of Black African family origin has controlled hypertension on amlodipine 10 mg daily but develops symmetrical ankle oedema. There is no breathlessness, raised JVP or weight gain. What is the most appropriate recommendation?

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Correct answer: E — Request review of the amlodipine dose or a different drug class

Dihydropyridine CCB oedema reflects arteriolar dilation and fluid redistribution rather than conventional sodium retention, so diuretics usually have little effect. After excluding heart failure and other causes, options include reducing the dose, changing CCB or switching drug class through the prescriber. The family-origin recommendation informs the replacement choice but does not justify an unsupervised ACE inhibitor switch.

Reference: NHS SPS CCB oedema guidance: https://www.sps.nhs.uk/articles/managing-peripheral-oedema-caused-by-calcium-channel-blockers/