Telmisartan in pa-tients with mild/moderate hypertension and chronic kid-ney disease. Clin Nephrol . 0. Yusuf S, Teo K, Anderson C, Effects of the angiotensin-receptor blocker  FTY720 telmisartan on cardiovas-cular events in high-risk patients intolerant to angioten 4 D.A. Schoeller cardiovascular events 4 and are rmended as st-or second-line antihypertensive agents. Although dihy-dropyridine CCBs are generally well-tolerat their use is limited by an increased risk for pedal ede a dose-of arm and leg lymphedema resulting from lymphatic obstruction. Bioimpedance was observed to be -to -fold more sensitive than arm-circumference mea-surements in the evaluation of brachial lymphedema in dependent adverse effect that occurs in 5 of pa-patients with breast cancer 5 and has been suggested as tien requires clinical monitori and limits dosing to maximally reduce blood pressure.

Dihydropyri-dine CCBs may cause vasodilatory edema by directly blocking L-type calcium  Apixaban channels expressed on vas-cular smooth muscle cells and creating pronounced dilation of precapillarypared with postcapillary resistance vessels. The relatively increased arteriolar dilation may lead to increased distal intracapillary pressu reduced water reupta and subsequent increased interstitial id. Clinical research in the development of antihyperten-sives requires ef ient and accurate tools for identifying pedal edema. In clinical practi pedal edema is evalu-ated using physical examination with a subjective grade scale to assess pitting on digital depression. Howev patient-reported symptoms of leg heaviness and swelling may precede clinical evidence of edema observed on physical  VX-950 402957-28-2 examination.

A response that can be detected earlier than pitting edema is increased leg volume. In the clinical trial setti water displacement volumetry is in-expensive and repro-ducibilityparable to ankle circumference and body weight and is considered to be the gold standardfor  buy HA-1077 measuring lower leg edema. The measurement of water displaceme howev is time-consuming and la-bor-intensi requiring as much as an hour of technician time for triplicate measures that include reling the water ta ensuring proper water temperatu and allowing for equilibration of water level before and after foot sub-mersion. The identi ation of an ef acious method that is more easily implemented would be a bene ial advance for research efforts. 1 Alternate methodologies used to gauge the potential of an agent to induce pedal edema in short-term clinical trials have not been reported in the lit-erature. Th the aim of this study was to identify a a tool for detecting edema prior to clinical assessments of edema.

In the present stu incremental changes in pedal edema from to weeks of once-daily dosing  anatomy with amlodipine 0 mg were evaluated using segmental bio-impedan water displacement volumet ankle cir-cumference tape measuremen and clinical assess-ment of pitting to determine which method is most ef acious for use in the clinical development of vas-orelaxants that do not induce pedal edema. Specifical it was hypothesized that -week administration of amlodipine 0 pared with place would be associated with a decrease in change from base-line.