OBJECTIVES: To assess the effectiveness of losartan 50 mg on Post dialysis euvolemic hypertensive patients against standard antihypertensive pharmacotherapy. METHODS: A multicentre, prospective, randomised, single blind trial was conducted at hospital university sains Malaysia, Kelantan Malaysia, to assess the effect of losartan 50mg once daily (OD) among post dialysis euvolumic hypertensive patients. Covariate Adaptive Randomization was used for allocation of participant to standard or treatment arm, and were followed up for eight weeks. Pre, intra and post dialysis session blood pressure measurements were recorded along with any adverse events. Wilcoxon statistical test was performed to note the difference in blood pressure from baseline. RESULTS: A total of 70 patients were randomised into standard (n=35) and treatment arm (n=35) and were followed for a period of 8 weeks. The mean baseline post dialysis systolic blood pressure of standard arm was 156.1(±14.3) mmHg as compared to treatment arm 157.7 (±13.3) mmHg. In the standard group, the mean post dialysis blood pressure dropped by 0.5 mmHg by the end of 4^thweek but increased by 0.5 mmHg by the next four weeks. However the treatment arm reported a drop of 2.8 mmHg of BP drop during 8 week trial period. Analysis suggests that there was a significant difference in blood pressure readings at the end of 8 weeks among patients treated with losartan (P <0.001) however no such statistical association was observed in standard arm (P 0.17). CONCLUSIONS: A slow, steady significant decline in post dialysis BP was observed among euvolumic hypertensive patients that were treated with losartan 50mg.