Comparative Effects Of Benazepril And Valsartan On Erythropoietin Levels In Essential Hypertensives

Objective:To study the interference of renin-angiotensin system on erythropoietin secretion and to compare the response of erythropoiesis to valsartan with benazepril, in essential hypertensive patients with normal renal function. Methods:Collection data of 90 essential hypertensive patients in Department of Cardiology of Provincial Hospital affiliated to Shandong University, from March 2010 to January 2011.In groupl 31 cases(mean age 67.9±11.3 years)had received valsartan (80mg/d) more than three weeks.In groupll 28 cases(mean age 63.2±10.9 years)had received benazepril (10mg/d) more than three weeks. In groupIII 31 cases(mean age 66.6±9.8 years)had received neither ACE inhibitors nor angiotensinⅡreceptor blockers for at least one month. In the next morning after hospitalization, the following parameters were processed using automated standard techniques:haemoglobin(Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH),mean corpuscular haemoglobin concentration (MCHC) and haematocrit(HCT) levels. Plasma erythropoietin was measured by enzyme-immuno-assay(R&D). All values are expressed as mean±1 SD. Non-paired Student's t-text was used for continuous data and the chi square test was used for discrete data. All statistical tests were two-sided. P values lower than 0.05 were considered as significant.Results:1. EPO:Compared with the control group, valsartan decreased erythropoietin levels significantly (12.266±2.898 IU/L vs control 14.259± 3.125IU/L,p=0.012), but they remained unchanged with benazepril (15.019±3.318IU/L vs control 14.259±3.125IU/L,p>0.05). Compared with benazepril valsartan decreased erythropoietin levels (12.266±2.898 IU/L vs 15.019±3.318IU/L,p=0.033).2. Hb:Hb levels were lowered in the valsartan group(135.26±15.78g/L vs control 144.26±14.04g/L,p=0.021),but they did not change in benazepril group(144.32±17.43g/L vs control 144.26±14.04g/L, p=0.988). Compared with benazepril, valsartan decreased Hb levels(135.26±15.78g/L vs 144.32±17.43g/L,p=0.041).3. Other parameters:MCHC of group I is lower than that of groupIII(330.71±8.72g/L vs 339.71±9.47g/L,p<0.05),but group I versus group II MHCH values showed no significant difference (330.71±8.72g/L vs 334.11±10.34g/L,p>0.05). Group II versus groupⅢMHCH values showed no significant difference(334.11±10.34g/L vs 339.71±9.47g/L,p>0.05). HCT, RBC, MCV and MCH did not change neither in valsartan group nor in benazepril group.Conclusions:Valsartan lowered erythropoietin secretion and haemoglobin levels in essential hypertensives. Benazepril can neither affect erythropoietin secretion nor 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.