Key result
Losartan 50 mg enabled 9.1% of post-dialysis euvolemic hypertensive patients to achieve the primary endpoint of post-dialysis blood pressure <140/90 mmHg, compared to 0% in the standard care arm.
Why the study?
Does losartan reduce blood pressure in post-dialysis euvolemic hypertensive patients?
RCT (n=88)
Single-blind
Covariate Adaptive Randomization
Yes
Does losartan reduce blood pressure in post-dialysis euvolemic hypertensive patients?
Losartan effectively reduces blood pressure in post-dialysis euvolemic hypertensive patients, highlighting the role of the renin-angiotensin-aldosterone system in this population.
Answers are grounded in this paper and cite their sources.
Losartan yields modest post-dialysis BP control; extends RAAS blockade evidence in euvolemic dialysis hypertension.
The aim of current study was to assess the effectiveness of losartan 50 mg in reducing blood pressure among post-dialysis euvolemic hypertensive patients, observing their survival trends and adverse events during the course of study. A multicentre, prospective, randomised, single-blind trial was conducted to assess the effect of losartan 50 mg every other day (EOD), once a morning (OM) among post-dialysis euvolemic hypertensive patients. Post-dialysis euvolemic assessment was done by a body composition monitor (BCM). Covariate Adaptive Randomization was used for allocation of participants to the standard or intervention arm. Of the total 229 patients, 96 (41.9%) were identified as post-dialysis euvolemic hypertensive. Final samples of 88 (40.1%) patients were randomized into standard and intervention arms. After follow-up of 12 months' pre-dialysis systolic (p < 0.001) and diastolic (p 0.01), intradialysis diastolic (p 0.02), post-dialysis systolic (p < 0.001) and diastolic (p < 0.001) blood pressure was reduced from the baseline among intervention-arm patients Compared to only pre-dialysis systolic blood pressure (p 0.003) among standard arm patients after 12 months of follow. Total of six deaths were reported among standard-arm patients compared to 2 deaths among the intervention arm. Losartan 50 mg achieve an overall significant decline in blood pressure among post-dialysis euvolemic hypertensive patients.
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Aftab et al. (2017) conducted an RCT in Post-dialysis euvolemic hypertension in end-stage renal disease (n=88). Losartan vs. Standard antihypertensive therapy (excluding RAAS inhibitors) was evaluated on Achieving a post-dialysis blood pressure of <140/90 mmHg and maintaining this for four weeks. Losartan 50 mg enabled 9.1% of post-dialysis euvolemic hypertensive patients to achieve the primary endpoint of post-dialysis blood pressure <140/90 mmHg, compared to 0% in the standard care arm.
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