Amlodipine-Induced Gingival Overgrowth: A Health Justice Issue

Abstract Hypertension is a leading cause of death and disability in the United States and worldwide. As primary care clinicians, nurse practitioners help patients control their blood pressure through lifestyle coaching and medication. Among the first-line medications for hypertension are calcium channel blockers, such as amlodipine. In the US, over 70 million prescriptions for amlodipine are written annually. Here we present a case report of a significant adverse event due to the use of amlodipine—gingival overgrowth. We review the pathophysiology, prevalence, and clinical management of gingival overgrowth. We also expand the understanding of this phenomenon by exploring the serious health justice implications of this adverse effect. Unchecked, gingival overgrowth can lead to tooth movement and eventual loss. Dental changes also cause pain, financial hardship, and psychosocial damage. Patients in poverty are at much greater risk for this adverse outcome due to limited access to dental care. Black patients specifically face a triple threat with higher rates of hypertension and its complications, guidelines that limit therapeutic options for first-line treatment, and high rates of poverty limiting access to dental care.