Clin J Am Soc Nephrol

Which antihypertensive drug class is least prone to intrahemodialysis hypotension?

November 1, 2024

Among hemodialysis patients, use of β- and α/β-blockers, ACE inhibitors or ARBs, and diuretics was associated with a higher risk of IDH, compared with calcium channel blockers (CCBs).

This emulation of a randomized clinical trial included 4,072 incident hemodialysis patients who started antihypertensive drug therapy between January 2016 and December 2019. Primary outcome was the occurrence of IDH during hemodialysis sessions.

IDH incidence rate among patients who initiated CCBs was 7.4 events per person-year (95% CI, 6.2-8.6). Relative to CCB use, use of β- and α/β-blockers was strongly associated with a higher likelihood of developing IDH (odds ratio [OR], 2.27; 95% CI, 1.50-3.43). Use of ACE inhibitors or ARBs (OR, 1.71; 95% CI, 1.14-2.57) and diuretics (OR, 1.52; 95% CI, 1.07-2.16) were also associated with a higher likelihood of IDH relative to CCBs.

Source:

Zoccali C, et al. (2024, October 1). Clin J Am Soc Nephrol. Antihypertensive Drug Treatment and the Risk for Intrahemodialysis Hypotension. https://pubmed.ncbi.nlm.nih.gov/39012707/