From the Guidelines
Compression stockings are generally safe and may be beneficial for individuals with high blood pressure and leg fluid retention, even after experiencing swelling from amlodipine, as they can help reduce leg swelling by applying graduated pressure that assists in moving fluid back into circulation. When considering the use of compression stockings, especially in the context of recent fluid retention exacerbated by amlodipine, it's crucial to weigh the benefits against potential risks. The key benefit of using compression stockings, as highlighted in a systematic review of 11 randomized trials including 2,906 individuals, is their ability to reduce the incidence of asymptomatic deep vein thrombosis (DVT) and, with less evidence, leg edema 1.
For individuals with a history of high blood pressure and fluid retention, starting with mild to moderate compression (15-20 mmHg) calf-height stockings would be an appropriate approach. It's essential to put them on first thing in the morning before swelling accumulates and remove them before bedtime. Ensuring they fit properly is also critical—too tight can restrict circulation, while too loose won't provide the desired benefits.
Given your specific situation, where amlodipine caused leg puffiness, the use of compression stockings could counteract the vasodilatory effects of such medications by creating external pressure that helps prevent the leakage of fluid from blood vessels into surrounding tissues. However, if you have other cardiovascular conditions like heart failure or peripheral artery disease, it's advisable to consult your healthcare provider before using compression stockings. The evidence from studies like the LONFLIT-3 study, although focused on thromboprophylaxis during travel, underscores the importance of preventive measures against venous thromboembolism (VTE) in at-risk populations, which may include individuals with a history of leg fluid retention and high blood pressure 1.
In terms of practical recommendations, strategies to prevent VTE, such as appropriate loose clothing, frequent walks, calf muscle exercises, use of elastic compression stockings, and adequate hydration, are beneficial for individuals at risk 1. Leg exercises have been shown to improve popliteal venous flow during prolonged immobility in seated individuals, further supporting the multifaceted approach to managing and preventing leg fluid retention and associated risks.
From the Research
Safety of Compression Stockings with High Blood Pressure and Fluid Retention
- The use of compression stockings may be beneficial in reducing fluid retention and swelling in the legs, as they help to improve blood flow and reduce blood pooling 2, 3.
- However, it is essential to consider the individual's medical history, including high blood pressure and fluid retention, before using compression stockings 4, 5.
- Amlodipine, a medication used to treat high blood pressure, can cause fluid retention and swelling in the legs as a side effect 4, 5.
- The use of compression stockings may help to mitigate this side effect, but it is crucial to consult with a healthcare professional before using them, especially if you have experienced fluid retention and swelling while taking amlodipine 4, 5.
Effects of Compression Stockings on Lower-Limb Venous and Arterial System
- Compression stockings can help to prevent blood pooling and reduce the risk of lower-extremity vascular complications, including deep vein thrombosis 2.
- However, the use of compression stockings may not preserve leg arterial flow-mediated dilation and reactive hyperemia response after prolonged sitting 2.
- The length of compression stockings may not significantly affect oedema, pain, and satisfaction, but knee-length stockings may be preferred over thigh-length stockings due to reduced side effects 6.
Recommendations for Using Compression Stockings
- Compression stockings with 25-32 mmHg pressure may be effective in reducing oedema and pain in individuals with fluid retention and swelling in the legs 6.
- It is recommended to consult with a healthcare professional before using compression stockings, especially if you have a history of high blood pressure, fluid retention, or swelling in the legs 4, 5, 3.
- Regular monitoring of blood pressure and fluid retention is essential while using compression stockings to ensure their safe and effective use 4, 5.