Comparative effects of fosinopril and irbesartan on hematopoiesis in essential hypertensives.
OBJECTIVE
To compare the response of erythropoiesis to an angiotensin receptor blocker, irbesartan with an angiotensin conversing enzyme inhibitor, fosinopril, in essential hypertensive patients with normal renal function.


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, hemoglobin (Hb) and hematocrit (Hc) levels were measured at start and monthly after receiving the treatment. All values are expressed as mean+/-1SD.


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 lowered in 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 neither in irbesartan group (baseline 40.9+/-3.7 vs. 40.8+/-3.3 %) nor in fosinopril group (baseline 14.6+/-1.3 vs. 14.5+/-1.3 %).


CONCLUSIONS
Irbesartan lowered erythropoietin secretion and hemoglobin levels in essential hypertensives. Fosinopril can neither influence erythropoietin secretion nor decrease hemoglobin levels. Angiotensin receptor blockers seem to get higher efficacy for antagonism angiotensin effects. Safety of angiotensin receptor blockers in anemic hypertensive patients should be studied.
Unidad de Hipertensión Arterial, Hospital Infanta Cristina, Badajoz, Spain. nroblesp@meditex.es
Nicolás Roberto
NR
Robles
E
E
Angulo
J
J
Grois
A
A
Barquero
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D001713:Biphenyl Compounds / Q000494:pharmacology*; D004906:Erythrocyte Count; D005260:Female; D005500:Follow-Up Studies; D017328:Fosinopril / Q000494:pharmacology*; D006410:Hematopoiesis / Q000187:drug effects*; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood*; D000077405:Irbesartan; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000494:pharmacology*; D013997:Time Factors
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001713:Biphenyl Compounds; D006454:Hemoglobins; D013777:Tetrazoles; D000077405:Irbesartan; D017328:Fosinopril