Impact of Angiotensin Receptor Blockers (ARB) versus Other Antihypertensive Medication on Blood Pressure in Patients on Dialysis: A Meta-Analysis

Author:

Devi D.S. Karthika1,Mary J. Jenifer Florence2,Mohan Reenaa1,Gavlasova Dominika3,Kalaiselvan G.4,Kathiravan E.5,Foppiani Jose A.6,Saravanan V.7,Devi M. Archana8,Lin Samuel J.9

Affiliation:

1. Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India

2. Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, SBV (Deemed to be University), Puducherry, India

3. IKEM, Cardiology Resident, Institute of Clinical and Experimental Medicine, Charles University, Prague, Czechia

4. Department of Community Medicine, AIIMS, Mangalgiri, Andhra Pradesh, India

5. Department of General Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India

6. BIDMC, Research Fellow, Division of Plastic Surgery, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts, US

7. Department of Community Medicine, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India

8. Sri Lalithambigai Medical College and Hospital, Adayalampattu, Maduravoyal, Chennai, Tamil Nadu, India

9. BIDMC, Division of Plastic Surgery, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts, US

Abstract

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.

Publisher

Scientific Scholar

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3