Antihypertensive Medications and Anemia

Sica, Domenic A.; Mannino, R

doi:10.1111/j.1524-6175.2007.06296.x

Cited by 22 publications

(23 citation statements)

References 53 publications

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“…In men, current use of anti-hypertensives and antidiabetics/insulin were negatively related to hemoglobin values. This was also consistent with previous reports [27,28]. Some types of antihypertensives cause hemodilution, hemolytic anemia, or suppress red cell production [27].…”

Section: Discussionsupporting

confidence: 82%

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Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

Imai¹,

Nakade²,

Tsuboyama³

et al. 2016

J Nutr Food Sci

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Objectives: This study aimed 1) to examine the trends in the prevalence of anemia of the Japanese elderly population and 2) to evaluate the association between hemoglobin concentrations and diet and lifestyle factors, by using data from a population-based, nationwide cross-sectional survey in Japan, from [2003][2004][2005][2006][2007][2008][2009]. Design:A cross-sectional nationally representative survey. Setting: Japan.Participants: A nationally representative sample of 10,606 community dwelling men (n=4656) and women (n=5950) aged 65 years and over.Measurements: Information on anthropometry, dietary intake status, information on current medication, lifestyle habits, and blood biomarker measurements were obtained from the participants. Anemia was defined as hemoglobin concentrations <130 g/L in men and <120 g/L in women. Logistic regression analysis adjusted for subject age was applied to estimate the effect of survey year to anemia prevalence. Multiple regression analysis was applied to estimate the effect of survey year and clinical, dietary and lifestyle factors to hemoglobin values.Results: Anemia prevalence was 19.3% in men and 21.7% in women. When adjusted for age, the prevalence of anemia significantly decreased by each survey year in both men (odds ratio: 0.933, 95% confidence interval: 0.899, 0.968, p<0.001) and women (odds ratio: 0.968, 95% confidence interval: 0.939, 0.999, p=0.040). The multivariate model explained 25% and 22% of the variance in hemoglobin values in men and women, respectively. In both men and women, each unit of increase in BMI, daily smoking, serum ferritin and albumin was positively associated to hemoglobin values, and age was negatively associated. After adjusting for all factors, hemoglobin values were estimated to increase 0.66 g/L per year in men, and 0.68 g/L per year in women. Conclusion:Nutritional status of the Japanese elderly as observed by anemia prevalence and hemoglobin concentrations has improved in recent years.

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Section: Discussionsupporting

confidence: 82%

“…This was also consistent with previous reports [27,28]. Some types of antihypertensives cause hemodilution, hemolytic anemia, or suppress red cell production [27]. Long term metformin treatment for diabetes suppresses absorption of vitamin B 12 , and may lead to anemia [28].…”

Section: Discussionsupporting

confidence: 80%

Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

Imai¹,

Nakade²,

Tsuboyama³

et al. 2016

J Nutr Food Sci

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“…Angiotensin II, a component of the regulatory pathway initiated by renin, acts directly as a growth factor through the AT1 receptor, stimulating proliferation of erythroid progenitors in bone marrow and, additionally, it enhances erythropoietin secretion (Vlahakos et al, 2010). This mechanism also explains anaemia that has been described as a side effect of drugs interfering with the renin-angiotensin system (Sica and Mannino, 2007).…”

Section: Blood Rheology and The Pathophysiology Of Hypertensionmentioning

confidence: 99%

Hemorheological abnormalities in human arterial hypertension

Presti

Hopps

Caimi

2014

Korea-Aust. Rheol. J.

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Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications.

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“…Overt clinical anemia is not a common side effect of methyldopa; it affects only some 1-5% of treated patients [8] . Accelerated eryptosis may be compensated by en- Fig.…”

Section: +mentioning

confidence: 99%

“…Side effects of methyldopa include hemolytic anemia [5][6][7] , which could affect 1-5% of patients [8] . In other conditions with hemolytic anemia, such as iron deficiency [9] , hemolytic uremic syndrome [10] and sepsis [11] , the accelerated clearance of circulating erythrocytes results at least in part from enhanced eryptosis, the suicidal death of erythrocytes [12] .…”

Section: Introductionmentioning

confidence: 99%

Stimulation of Erythrocyte Cell Membrane Scrambling by Methyldopa

Mahmud

Föller²,

Läng³

2008

Kidney Blood Press Res

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Methyldopa is used for treatment of hypertension in pregnancy. Side effects of methyldopa include anemia, which could result from decreased formation or accelerated death of circulating erythrocytes. Several drugs cause anemia by triggering of suicidal erythrocyte death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling, the latter leading to phosphatidylserine exposure at the erythrocyte surface. Stimulators of erythrocyte membrane scrambling include increased cytosolic Ca²⁺ concentration ([Ca²⁺]_i) and ceramide. Phosphatidylserine-exposing cells are rapidly cleared from circulating blood. The present study explored whether eryptosis could be triggered by methyldopa. Erythrocytes from healthy volunteers were exposed to methyldopa, and phosphatidylserine exposure (annexin A5 binding), cell volume (forward scatter), [Ca²⁺]_i (Fluo3-dependent fluorescence), and ceramide formation (anti-ceramide-fluorescein isothiocyanate antibody) were determined by flow cytometry. Methyldopa (6 μg/ml) did not increase [Ca²⁺]_i but led to stimulation of ceramide formation resulting in significant phosphatidylserine exposure and, at higher concentrations, to cell shrinkage. Methyldopa further decreased the GSH/GSSG ratio, pointing to oxidative stress. The scavenger N-acetyl-L-cysteine significantly blunted methyldopa-induced eryptosis. Clearance of erythrocytes from circulating blood was significantly accelerated by treatment with methyldopa. The present observations disclose a novel action of methyldopa, which may well contribute to drug-induced anemia.

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Antihypertensive Medications and Anemia

Cited by 22 publications

References 53 publications

Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

Hemorheological abnormalities in human arterial hypertension

Stimulation of Erythrocyte Cell Membrane Scrambling by Methyldopa

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