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Ten percent to 20% of patients on dialysis die annually, and about half of such deaths are caused by adverse cardiovascular events. No specific intervention has been shown to lower risks for these outcomes; in particular, trials of blood pressure–lowering agents in this population have produced conflicting results.
In a meta-analysis of eight randomized controlled trials (involving 1679 adult dialysis patients with and without baseline hypertension), researchers assessed the effects of blood pressure–lowering drugs on cardiovascular outcomes. Active agents were angiotensin-receptor blockers, angiotensin-converting–enzyme inhibitors, β-blockers, and calcium-channel blockers; comparators were placebo and usual treatment; follow-up ranged from …