Related Experiment Video
Updated: Jun 11, 2025
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Impact of Angiotensin Receptor Blockers (ARB) versus Other Antihypertensive Medication on Blood Pressure in Patients
Karthika Devi D S1, J Jenifer Florence Mary2, Reenaa Mohan1
1Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Insights
Angiotensin-II receptor blockers (ARBs) and other antihypertensive drugs show similar effectiveness in managing hypertension for dialysis patients. This meta-analysis found no significant difference in blood pressure reduction or adverse events between ARBs and other agents.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Hypertension is a major cause of mortality in dialysis patients.
- Angiotensin-II receptor blockers (ARBs) are effective antihypertensives with fewer side effects than ACE inhibitors.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of ARBs compared to other antihypertensive agents in adult dialysis patients with hypertension.
Main Methods:
- A systematic search of multiple databases (PubMed, MEDLINE, SCOPUS, etc.) was conducted until February 2023.
- Included studies involved adult dialysis patients (≥18 years) and compared ARBs with other antihypertensives.
- Data on systolic and diastolic blood pressure changes and adverse events were pooled using a random-effects model.
Main Results:
- The meta-analysis included 13 studies with 1,462 patients.
- No statistically significant differences were found in pre- or post-dialysis systolic or diastolic blood pressure reduction between ARBs and other antihypertensive agents.
- Adverse events were not significantly different between ARB and other antihypertensive groups.
Conclusions:
- ARBs and other antihypertensive medications demonstrate comparable efficacy in treating hypertension among dialysis patients.
- The findings suggest that ARBs are a viable alternative to other antihypertensives in this population, with similar safety profiles.
Introduction:
Hypertension is an important factor driving mortality among dialysis patients. Angiotensin-II receptor blocker (ARB) has been effective similarly to angiotensin-converting enzymes (ACEs) but with a low incidence of side effects.
Methodology:
The meta-analysis included all published studies that investigated the effect of ARB on the hypertension in adult dialysis patients (≥18 years). Data extraction was guided by a predetermined checklist. Data sources of the retrieved studies were PubMed, MEDLINE, ScienceDirect, SCOPUS, Cochrane, Web of knowledge, and Google Scholar were systematically searched until February 2023. Using the RevMan 5 software, the mean difference for systolic and diastolic BP (SBP and DBP) and the risk ratio (RR) of the adverse events (AEs) were pooled from the selected studies. The random-effects model was used to compare the difference in the pre-and post-dialysis of the SBP and DBP. Data analyses were performed from December 2022 to February 2023. The primary outcome was the reduction in SBP and DBP in dialysis hypertensive patients who were on anti-hypertensive agents, and the secondary outcome was assessment of AE associated with the drug after dialysis (PROSPERO Registration: CRD42022355369).
Results:
The initial search yielded 1,679 records, of which 84 studies underwent full-text evaluation, which identified 13 studies and 1,462 patients. The pooled standard MD for losartan with other anti-hypertensive agents, where the pre-dialysis SBP was 0.17 (95% confidence interval [CI]: -0.21-0.55) and the post-dialysis was 0.35 (95% CI: -0.17-1.02); yet, both are statistically non-significant, implies that there was no difference between Losartan and ARB drugs regarding the effect on the SBP. Diastolic BP for predialysis was -0.01 (95% CI: -0.65-0.63) and post-dialysis was 0.03 (95% CI: -0.24-0.30) and statistically non-significant. AEs by the ARB agents were lower compared to other anti-antihypertensive agents (relative risk [RR]: 1.01; 95% CI: 0.59-1.75) and statistically non-significant.
Conclusion:
This systematic review and meta-analysis of RCT demonstrated that ARB and other anti-hypertensive medications had similar impacts on the treatment of hypertension.
Related Concept Videos
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:16Antihypertensive Drugs: Action of Diuretics
01:17Antihypertensive Drugs: Action of β1 Blockers