Amlodipine-Induced Junctional Bradycardia in an Elderly Patient with Resistant Hypertension: A Case Report

Amlodipine, a dihydropyridine calcium channel blocker, is widely prescribed for hypertension due to its vasodilatory effects and minimal influence on heart rate. However, rare cases of bradycardia have been reported, particularly in elderly patients with multiple comorbidities. We describe the case of an 84-year-old male with chronic resistant hypertension and stage III chronic kidney disease who developed asymptomatic junctional bradycardia while on amlodipine 10 mg daily as part of a multidrug antihypertensive regimen. Laboratory workup excluded electrolyte abnormalities, thyroid dysfunction, and myocardial infarction. Amlodipine was discontinued, resulting in resolution of bradycardia 48 hours later. This case highlights the potential for amlodipine to cause clinically significant bradycardia even at therapeutic doses, particularly in elderly patients with polypharmacy and impaired renal function. Early recognition may prevent unnecessary invasive interventions.