The cardiovascular effects of erythropoietin

Cardiovasc Res. 2003 Sep 1;59(3):538-48. doi: 10.1016/s0008-6363(03)00468-1.


Erythropoietin is a hypoxia-induced hormone that is essential for normal erythropoiesis. The production of recombinant human erythropoietin (rHuEpo) has revolutionized the treatment of anemia associated with chronic renal failure and chemotherapy, and has been used as prophylaxis to prevent anemia after surgery. The erythropoietin receptor is widely distributed in the cardiovascular system, including endothelial cells, smooth muscle cells and cardiomyocytes. Epo has potentially beneficial effects on the endothelium including anti-apoptotic, mitogenic and angiogenic activities. On the other hand, some reports suggest that rHuEpo may have pro-thrombotic or platelet-activating effects. Hypertension develops in 20-30% of renal patients treated with rHuEpo. Many patients with heart failure have anemia. Despite some potential adverse effects, early studies in heart failure patients with anemia suggest that rHuEpo therapy is safe and effective in reducing left ventricular hypertrophy, enhancing exercise performance and increasing ejection fraction. Further studies are warranted to define the role of rHuEpo in chronic heart failure and other cardiovascular settings.

Publication types

  • Review

MeSH terms

  • Anemia / drug therapy
  • Anemia / prevention & control
  • Cardiovascular System / metabolism*
  • Cell Division / drug effects
  • Chromogranins
  • Endothelium, Vascular / drug effects
  • Erythropoietin / adverse effects
  • Erythropoietin / metabolism*
  • Erythropoietin / therapeutic use
  • GTP-Binding Protein alpha Subunits, Gs*
  • Heart Failure / drug therapy
  • Humans
  • Hypertension / chemically induced
  • Kidney Failure, Chronic / drug therapy
  • Muscle, Smooth, Vascular / drug effects
  • Myocytes, Cardiac / drug effects
  • Nerve Tissue Proteins / therapeutic use
  • Platelet Activation
  • Receptors, Erythropoietin / metabolism
  • Recombinant Proteins
  • Thrombosis / chemically induced


  • Chromogranins
  • Nerve Tissue Proteins
  • Receptors, Erythropoietin
  • Recombinant Proteins
  • Erythropoietin
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs