A Comparison of the Efficacy and Renal Side Effects of Antihypertensive Drugs "Angiotensin Receptor Blockers" (ARBs) in Rajavithi Hospital.

BACKGROUND

Hypertension is a major public health problem. As a result of the enforcement of measures announced by the National Drug Committee, the majority of original drugs is no longer prescribed and is replaced with drugs in the national list of essential medicines. Patients originally taking Angiotensin receptor blockers (ARBs) frequently have their prescription changed to generic losartan. Only a few studies have been conducted in Thailand to compare the efficacy and renal side effects of original and generic drugs.

OBJECTIVE

To compare blood pressure (both systolic and diastolic) of patients who were changed to losartan from other ARBs.

MATERIAL AND METHOD: A retrospective cross-sectional study was carried out, collecting data from medical records of patients with hypertension who were prescribed losartan instead of other ARBs in Rajavithi Hospital from 1 January 2009 to 31 December 2014. One hundred patients with hypertension during this period were enrolled, and the drugs' relative efficacies in controlling blood pressure were compared, together with their renal side effects.

RESULTS

The study enrolled 100 patients, of which 35% were men, and the mean age was 66.88 ± 10.93 years. The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after changing from other A RBs to losartan showed a significant difference (134.16 ± 12.89 vs. 140.92 ± 11.76 mmHg, p-value < 0.001) and (74.22 ± 8.05 vs. 76.52 ± 8.88 mmHg, p-value = 0.001, respectively). Other ARBs controlled hypertension significantly better than losartan (70.0% vs. 32.0%, p-value <0.001). Serum creatinine was significantly higher after changing the blood pressure lowering regimen (0.9 7 ± 0.3 7 vs. 1.00 ± 0.3 7 mg/dl, p-value = 0.047), but serum potassium levels did not change (4.27 ± 0.40 vs. 4.27 ± 0.32 mEq/L, p-value = 0.888).

CONCLUSION

Original A RBs controlled hypertension significantly better than losartan. Serum creatinine levels were lower when A RBs were prescribed rather than losartan; however, serum potassium levels were not affected.