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However, the optimal treatment algorithm\nof hypertension remains elusive; extrapolation of clinical-trial evidence from the general population\nmay not be optimal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>For this narrative review, we searched the Medline\/PubMed database (inception to August 01,\n2019) to identify randomized clinical trials evaluating the efficacy of antihypertensive drugs on CV\noutcomes and mortality in patients on hemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Randomized trials with angiotensin-converting-enzyme-inhibitors (ACEIs) or angiotensinreceptor-\nblockers (ARBs) failed to provide consistent cardioprotection. \u03b2-blockers may provide a more\nconsistent CV benefit. Although some early clinical trials have shown that mineralocorticoid-receptorantagonists\n(MRAs) reduce CV mortality, the associated risk of hyperkalemia raises important safety\nconcerns on the use of MRAs as add-on therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our first-line therapy of hypertension in hemodialysis is the assessment and management\nof dry-weight and optimization of dialysis prescription. Based on the available clinical-trial evidence,\nwe prescribe atenolol 3 times\/week after dialysis as the first-line pharmacological option of hypertension\nto our patients without specific indications for other agents. Long-acting dihydropyridines and\nACEIs\/ARBs are our second-line and third-line choices, respectively. We avoid using MRAs and await\nresults from ongoing trials testing their safety and efficacy. In patients receiving maintenance hemodialysis,\nrandomized trials are clearly warranted in order to define BP targets and the comparative effectiveness\nof different antihypertensive drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2174\/1570161118666200317151000","type":"journal-article","created":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T10:24:41Z","timestamp":1584440681000},"page":"12-20","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antihypertensive Therapy in Patients Receiving Maintenance Hemodialysis: A Narrative Review of the Available Clinical-Trial Evidence"],"prefix":"10.2174","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-2096","authenticated-orcid":true,"given":"Panagiotis I.","family":"Georgianos","sequence":"first","affiliation":[{"name":"Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. 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