|Robles NR et al.|
Comparative Effects of Fosinopril and Irbesartan on Haematopoiesis in Essential Hypertension
Journal of Clinical and Basic Cardiology 2003; 6 (1-4): 45-47
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Keywords: ACE-Hemmer, Angiotensin, Angiotensinrezeptorantagonist, Fosinopril, Hypertonie, Hämatopoiese, Irbesartan, Kardiologie, ACE-Inhibitor, Angiotensin, Angiotensin receptor antagonist, cardiology, Fosinopril, Haematopoiesis, hypertension, Irbesartan
Objective: To compare the response of erythropoiesis to an angiotensin receptor blocker, irbesartan with an angiotensin converting enzyme inhibitor, fosinopril, in essential hypertensive patients with normal renal function. Design and Methods: Thirty patients were randomized to receive either irbesartan (150 mg once daily) (n = 15, mean age 65.2 ± 8.7 years) or fosinopril (20 mg once daily) (n =15, mean age 57.4 ± 11.5 years, difference is not significant) during 12 weeks. Plasma erythropoietin, haemoglobin (Hb) and haematocrit (Hc) levels were measured at start and monthly after receiving the treatment. All values are expressed as mean ± 1 SD. Results: Irbesartan decreased erythropoietin levels (baseline 20.7 ± 1.3 vs. 18.1 ± 3.7 mU/ml, p = 0.019), but they remained unchanged with fosinopril (baseline 18.8 ± 1.3 vs. 18.6 ± 1.6 mU/ml). Hb levels were lowered in the irbesartan group (baseline 13.8 ± 1.2 vs. 13.5 ± 1.1 g/dl, p = 0.029), but they did not change in fosinopril treated patients (baseline 14.6 ± 1.3 vs. 14.5 ± 1.3 g/dl). Hc did not show any change either in the irbesartan group (baseline 40.9 ± 3.7 vs. 40.8 ± 3.3 %) or in the fosinopril group (baseline 14.6 ± 1.3 vs. 14.5 ± 1.3 %). Conclusions: Irbesartan lowered erythropoietin secretion and haemoglobin levels in essential hypertensives. Fosinopril can neither influence erythropoietin secretion nor decrease haemoglobin levels. Angiotensin receptor blockers seem to get higher efficacy for antagonizing angiotensin effects. Safety of angiotensin receptor blockers in anaemic hypertensive patients should be studied.