A Comparison of the Efficacy and Renal Side Effects of Antihypertensive Drugs “Angiotensin Receptor Blockers” (ARBs) in Rajavithi Hospital
Surapun Pongsuthana MD*, Kittiwat Chutpongtada MD*
Affiliation : * Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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 ARBs 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
(0.97+0.37 vs. 1.00+0.37 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 ARBs controlled hypertension significantly better than losartan. Serum creatinine levels were lower
when ARBs were prescribed rather than losartan; however, serum potassium levels were not affected.
Keywords : ARBs, Angiotensin receptor blockers, Hypertension, Renal function
