{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:03:55Z","timestamp":1777878235741,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Renin\u2013angiotensin system (RAS) blockade by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) has been related to anemia in various situations. We aimed to investigate whether discontinuation of RAS inhibitors improves erythropoiesis in patients with lower-risk myelodysplastic syndromes (LR-MDSs). Seventy-four patients with LR-MDS were divided into three groups matched for gender and age. Group A consisted of 20 hypertensive patients who discontinued RAS inhibitors and received alternative medications. Group B consisted of 26 patients who continued to receive ACEi\/ARB and Group C included 28 patients (50% hypertensive) never exposed to ACEi\/ARB. Half of the patients in each group were under treatment with recombinant human erythropoietin (rHuEPO). Data were collected at baseline and after 3, 6 and 12\u2009months. Group A showed a significant increase in hemoglobin from 10.4\u2009\u00b1\u20091g\/dL at baseline to 12.6\u2009\u00b1\u20091.2\u2009g\/dL after 12\u2009months ( p\u2009=\u20090.035) and in hematocrit (31.4\u2009\u00b1\u20093% versus 37.9\u2009\u00b1\u20094%, p\u2009=\u20090.002). Incident anemia decreased from 100% at baseline to 60% at 12\u2009months ( p\u2009=\u20090.043) despite a concomitant dose reduction in rHuEPO by 18% ( p\u2009=\u20090.035). No changes in hemoglobin and hematocrit were observed in both Group B and Group C. In the subset of patients not treated with rHuEPO, improvement of erythropoiesis was found only in Group A, as measured by changes in hemoglobin (11.5\u2009\u00b1\u20091\u2009g\/dL versus 12.4\u2009\u00b1\u20091.3\u2009g\/dL, p\u2009=\u20090.041) and hematocrit (34.5\u2009\u00b1\u20093% versus 37.1\u2009\u00b1\u20094%, p\u2009=\u20090.038) after 12\u2009months. In contrast, Group B and Group C decreased hemoglobin and hematocrit after 12\u2009months ( p\u2009&lt;\u20090.05). In conclusion, discontinuation of ACEi\/ARB in LR-MDS patients is followed by a significant recovery of erythropoiesis after 12\u2009months.<\/jats:p>","DOI":"10.1177\/2040620720958299","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T22:09:57Z","timestamp":1610662197000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Discontinuation of the renin\u2013angiotensin system inhibitors improves erythropoiesis in patients with lower-risk myelodysplastic syndromes"],"prefix":"10.1177","volume":"12","author":[{"given":"George","family":"Pavlidis","sequence":"first","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-837X","authenticated-orcid":false,"given":"Sotirios G.","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine - Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, 1 Rimini St., Haidari, Athens, 12462, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efthimia","family":"Bazani","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthi","family":"Bouchla","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eirini","family":"Glezou","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Gkontopoulos","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Thomopoulos","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasiliki","family":"Pappa","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demetrios V.","family":"Vlahakos","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine \u2013 Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School, University General Hospital \u201cAttikon\u201d, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"key":"bibr1-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu180"},{"key":"bibr2-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2011.06.001"},{"key":"bibr3-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"bibr4-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.6.2079"},{"key":"bibr5-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-420489"},{"key":"bibr6-2040620720958299","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(00)00100-4"},{"key":"bibr7-2040620720958299","first-page":"12","volume":"25","author":"Casadevall N.","year":"1998","journal-title":"Semin 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