PMID- 37750935
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240215
IS  - 1432-1912 (Electronic)
IS  - 0028-1298 (Linking)
VI  - 397
IP  - 3
DP  - 2024 Mar
TI  - Impact of calcium channel blockers and angiotensin receptor blockers on 
      hematological parameters in type 2 diabetic patients.
PG  - 1817-1828
LID - 10.1007/s00210-023-02731-y [doi]
AB  - Antihypertensive medications have been associated with a reduction in hemoglobin 
      (Hb) levels, leading to clinically significant anemia. We aimed to provide 
      valuable insights into the impact of angiotensin receptor blockers (ARBs) and 
      calcium channel blockers (CCBs) on hematological parameters by measuring the 
      levels of erythropoietin (EPO), ferritin, and complete blood count (CBC) in 
      individuals with type 2 diabetes mellitus (T2DM), particularly considering the 
      duration of the antihypertensives use. In addition to comparing their effects on 
      blood pressure, glycemic status, and renal function, a retrospective cohort study 
      was conducted at the consultation unit of Alsalam Teaching Hospital, Mosul, 
      Nineveh Province, between October 2022 and February 2023. A total of 160 
      participants were enrolled after being fully examined by the consultants to 
      detect their eligibility for inclusion in the study and to rule out any 
      abnormality. They consisted of 40 healthy controls, 30 T2DM patients (T2DM 
      group), 30 T2DM patients with newly diagnosed hypertension (HT) (T2DM+HT group), 
      30 type 2 diabetic-hypertensives on ARBs (T2DM+HT+ARBs group), and 30 type 2 
      diabetic-hypertensives on CCBs (T2DM+HT+CCBs group). Five milliliters of blood 
      was drawn from a vein and divided into two parts. Two milliliters was transferred 
      into an anticoagulant tube for the measurement of HbA1c and complete blood 
      picture. Serum was obtained from the remaining blood and used for assessment of 
      ferritin, EPO, FSG, creatinine, urea, and uric acid. Significantly reduced FSG 
      and HbA1c levels were observed in T2DM+HT+CCBs and T2DM+HT+ARBs groups vs T2DM+HT 
      group (p < 0.05). The T2DM+HT+CCBs group had statistically higher urea levels 
      than the T2DM group (p < 0.05). Both CCBs and ARBs use resulted in reduced 
      creatinine clearance (CrCl). T2DM+HT+CCBs group exhibited slightly higher uric 
      acid levels compared to controls (p < 0.05). Prolonged use of CCBs and ARBs led 
      to disturbances in hematological parameters, with CCBs users showing the lowest 
      levels of hemoglobin (Hb), RBCs, and hematocrit (Hct) among the groups. ARBs 
      users displayed the lowest values of EPO and ferritin compared to other patient 
      groups, along with reduced levels of Hb, RBCs, and Hct, albeit slightly higher 
      than CCBs users. Our study highlights the importance of a balanced approach in 
      prescribing ARBs and CCBs to patients with T2DM, given their potential to induce 
      blood abnormalities, particularly with prolonged usage.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Ahmed, Ghada M
AU  - Ahmed GM
AD  - Nineveh Health Directorate, Mosul, Nineveh Province, Iraq.
FAU - Abed, Mohammed N
AU  - Abed MN
AD  - Department of Pharmaceutical Chemistry, Mosul, Nineveh Province, Iraq. 
      m.n.abed@uomosul.edu.iq.
AD  - College of Pharmacy, University of Mosul, University Street, Mosul, 41002, 
      Nineveh Province, Iraq. m.n.abed@uomosul.edu.iq.
FAU - Alassaf, Fawaz A
AU  - Alassaf FA
AD  - College of Pharmacy, University of Mosul, University Street, Mosul, 41002, 
      Nineveh Province, Iraq.
AD  - Department of Pharmacology and Toxicology, Mosul, Nineveh Province, Iraq.
AD  - College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq.
LA  - eng
PT  - Journal Article
DEP - 20230926
PL  - Germany
TA  - Naunyn Schmiedebergs Arch Pharmacol
JT  - Naunyn-Schmiedeberg's archives of pharmacology
JID - 0326264
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - AYI8EX34EU (Creatinine)
RN  - 268B43MJ25 (Uric Acid)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Hemoglobins)
RN  - 8W8T17847W (Urea)
RN  - 9007-73-2 (Ferritins)
SB  - IM
MH  - Humans
MH  - Calcium Channel Blockers/therapeutic use
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Angiotensin Receptor Antagonists/therapeutic use
MH  - Glycated Hemoglobin
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Creatinine
MH  - Retrospective Studies
MH  - Uric Acid
MH  - Antihypertensive Agents/therapeutic use
MH  - *Hypertension/drug therapy
MH  - Hemoglobins
MH  - Urea
MH  - Ferritins/therapeutic use
OTO - NOTNLM
OT  - Anemia
OT  - Angiotensin
OT  - Calcium
OT  - Erythropoietin
OT  - Hypertension
OT  - Type 2 diabetes mellitus
EDAT- 2023/09/26 13:43
MHDA- 2024/02/11 16:42
CRDT- 2023/09/26 11:06
PHST- 2023/08/25 00:00 [received]
PHST- 2023/09/20 00:00 [accepted]
PHST- 2024/02/11 16:42 [medline]
PHST- 2023/09/26 13:43 [pubmed]
PHST- 2023/09/26 11:06 [entrez]
AID - 10.1007/s00210-023-02731-y [pii]
AID - 10.1007/s00210-023-02731-y [doi]
PST - ppublish
SO  - Naunyn Schmiedebergs Arch Pharmacol. 2024 Mar;397(3):1817-1828. doi: 
      10.1007/s00210-023-02731-y. Epub 2023 Sep 26.