Losartan reduces blood pressure in euvolemic hypertension after dialysis
Losartan at 50 mg is effective in reducing blood pressure in patients with postdialysis euvolemic hypertension, a recent study has shown.
Researchers performed a multicentre, randomized, prospective, single-blind trial including 88 postdialysis euvolemic patients with systolic blood pressure >140 mm Hg who were then randomized to receive either standard antihypertensive therapy or losartan alone or in combination with antihypertensives.
In the standard-arm group, blood pressure improved from a predialysis baseline value of 167.5±18.2 to 162.4±10.2 mm Hg after the 12-month follow-up, resulting in a significant drop of 5.1 mm Hg (p=0.003). In comparison, blood pressure in the losartan group also significantly dropped from 168.65±16.33 mm Hg at baseline to 158.45±10.65 mm Hg after 12 months (difference, 10.23 mm Hg; p<0.001).
On the other hand, postdialysis blood pressure was only significantly improved in the losartan group, with the baseline value of 156.34±13.40 mm Hg dropping to 149.73±10.21 mm Hg after 12 months. The difference of 6.6 mm Hg reached statistical significance (p<0.001).
There were more deaths in the standard arm than in the losartan group (13.6 vs 4.5 percent), resulting in respective survival probabilities of 84 and 95 percent. However, Kaplan-Meier analysis showed no significant difference in survival between the groups.
In terms of adverse events, losartan was found to be related to two cases of hyperkalaemia, four cases of coughs, three cases of dizziness, and one case of dyspepsia.
Finally, simple linear regression showed that diabetes was significantly associated with postdialysis systolic blood pressure in both the standard-arm (p=0.03) and losartan (p=0.02) treatment groups.