Effectiveness of enalapril for lowering extremity edema caused by levamlodipine in essential hypertensive population: a randomized comparison to furosemide

Background The incidence of leg edema caused by calcium channel blockers(CCB) is so high, some studies tried combination with angiotension converting enzyme inhibitors(ACEI) or diuretics to overcome this problem.However, there is no comparison about which is better to improve edema at present. Methods This study was designed as a single-center, prospective, randomized, double-blind, parallel-group, clinical trial. 224 hypertensive patients with leg edema after 4 weeks since taking levamlodipine were enrolled, and they were randomly divided into levamlodipine + furosemide(CD) group and levamlodipine + enalapril(CA) group for another 4 weeks. Ankle circumference(AC), edema score(ES), blood pressure(BP) and cure rate of leg edema were evaluated. Results Altogether 179 patients(89 in CD group and 90 in CA group) completed the 4-week treatment. After the 4-week therapy with furosemide or enalapril, most subjects were free of edema in either group(96.51% vs.96.67%, P > 0.05). Only 4 in CD group and 3 in CA group had mild edema. Enalapril was more effective than furosemide to reduce AC(10.92 ± 1.84 mm vs. 12.97 ± 2.46 mm, P < 0.05). But for ES, there was no significant difference. And there were no significant differences in antihypertensive effect between them. Uric acid(UA)was increased significantly in CD group(10.70 ± 18.48 μmol/L vs. 0.22 ± 28.13 μmol/L, P < 0.05). Conclusion Enalapril is more effective than furosemide in attenuating lower extremity edema caused by levamlodipine in essential hypertensive population, with equal antihypertensive efficacy and less uric acid increasing.