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The Interplay Of The Angiotensin Receptor Blockers And Haematological Abnormalities: Insights And Implications
Ghada Muthana Ahmed1, Fawaz Abdulghani Alassaf2, Muhammad Najim Abed3
1Nineveh health directorate, Mosul, Nineveh province, Iraq.
Insights
Angiotensin receptor blockers (ARBs), used beyond hypertension, may cause anemia by inhibiting erythropoiesis. Dose adjustment or discontinuation of ARBs can help correct this hematological abnormality, guided by clinical needs.
Area of Science:
- Pharmacology
- Nephrology
- Cardiology
Background:
- Angiotensin receptor blockers (ARBs) are increasingly prescribed for conditions beyond hypertension, including heart failure and diabetes.
- Their reno-protective and cardioprotective effects are well-documented.
- Conflicting data exists regarding ARBs' impact on hematological parameters.
Purpose of the Study:
- To investigate the relationship between angiotensin receptor blockers (ARBs) and hematological abnormalities, specifically anemia.
- To elucidate the mechanism by which ARBs may influence red blood cell production.
Main Methods:
- A comprehensive literature search was conducted using relevant keywords.
- Databases searched included PubMed, Cochrane Library, and Google Scholar.
- Studies published in English before January 2024 were included.
Main Results:
- Angiotensin II plays a crucial role in stimulating erythropoiesis.
- ARBs inhibit angiotensin II, potentially leading to reduced erythropoiesis.
- This inhibition can result in decreased hematocrit levels and the development of anemia.
Conclusions:
- ARBs can lower hematocrit levels and cause anemia due to the inhibition of erythropoiesis.
- Dose reduction or cessation of ARBs may be considered to manage ARB-induced anemia.
- Management decisions must be individualized based on the patient's clinical status and therapeutic requirements.
Abstract:
Antihypertensive medications known as angiotensin receptor blockers (ARBs) have become increasingly popular for treating conditions beyond hypertension. The reason for this widespread use is mainly due to its reno-protective and cardioprotective properties in patients with congestive heart failure and diabetes mellitus. There have been conflicting studies on the relationship between ARBs and haematological abnormalities. Using the supplied search terms, we carried out a thorough search for relevant papers written in English and published before January 2024. All of the studies that met the selection criteria were searched for on PubMed, Cochrane Library, and Google Scholar. Based on the examined data from the searched literature, it has been demonstrated that angiotensin II is essential for the stimulation of erythropoiesis and inhibition of it by drugs such as ARBs can lower haematocrit levels, leading to anaemia. Accordingly, dose reduction or stopping the administration of ARBs could be a choice to correct anaemia. However, such a decision is based on the clinical situation and the requirements for other management options.
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