Impact of Calcium Channel Blockers and Angiotensin Receptor Blockers on Hematological Parameters in Type 2 Diabetic Patients

Abstract

Background Antihypertensive medications have been associated with a reduction in hemoglobin (Hb) levels, leading to clinically significant anemia. Aim We aimed to provide valuable insights into the impact of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on hematological parameters in individuals with type 2 diabetes mellitus (T2DM), particularly considering the duration of their use. Methods A total of 160 participants were enrolled, consisting 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). Results Significantly reduced FSG and HbA1c levels were observed in T2DM + HT + CCBs and T2DM + HT + ARBs groups vs T2DM + HT group (p < 0.05). T2DM + HT + CCBs group had statistically higher urea levels than 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 showed the lowest levels of hemoglobin (Hb), RBCs, and hematocrit (Hct) among the groups. ARBs users displayed the lowest values of erythropoietin (EPO) and ferritin compared to other patient groups, along with reduced levels of Hb, RBCs, and Hct, albeit slightly higher than CCBs users. Conclusion 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.