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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/28324033/effect-of-moxonidine-on-the-aldosterone-renin-ratio-in-healthy-male-volunteers
#1
Ashraf H Ahmed, Richard D Gordon, Gregory Ward, Martin Wolley, Brett C McWhinney, Jacobus P Ungerer, Michael Stowasser
Background: The most popular screening test for primary aldosteronism (PA) is the plasma aldosterone/ renin ratio (ARR). Medications, dietary sodium, posture and time of day all affect renin and aldosterone levels, and can result in false negative or positive ARRs if not controlled. Most antihypertensive medications affect the ARR and can interfere with interpretation of results. To our knowledge, no study has been undertaken to evaluate the effects of moxonidine on the ARR. Methods: Normotensive, non-medicated male volunteers (n=20) underwent measurement (seated, midmorning) of plasma aldosterone (by HPLC-tandem mass spectrometry), direct renin concentration (DRC), renin activity (PRA), cortisol, electrolytes and creatinine and urinary aldosterone, cortisol, electrolytes and creatinine at baseline, and after one week of moxonidine at 0...
March 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323995/renin-phenotypes-characterize-vascular-disease-autonomous-aldosteronism-and-mineralocorticoid-receptor-activity
#2
Gregory L Hundemer, Rene Baudrand, Jenifer M Brown, Gary Curhan, Gordon H Williams, Anand Vaidya
Context: Mild cases of autonomous aldosterone secretion may go unrecognized using current diagnostic criteria for primary aldosteronism (PA). Objective: To investigate whether the inability to stimulate renin serves as a biomarker for unrecognized autonomous aldosterone secretion and mineralocorticoid receptor (MR) activation. Participants: 663 normotensive and mildly hypertensive participants, who were confirmed to not have PA using current guideline criteria and were on no antihypertensive medications...
February 17, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28322753/myeloperoxidase-asymmetric-dimethyl-arginine-and-the-renin-angiotensin-aldosterone-system-in-cardiovascular-risk-patients-cross-sectional-findings-from-the-ludwigshafen-risk-and-cardiovascular-health-luric-study
#3
Sieglinde Zelzer, Dietmar Enko, Stefan Pilz, Andreas Tomaschitz, Winfried März, Andreas Meinitzer
OBJECTIVES: The leukocyte-derived myeloperoxidase (MPO), the nitric oxidase synthase (NOS) inhibitor asymmetrical dimethyl-arginine (ADMA) and the renin-angiotensin-aldosterone-system (RAAS) are associated with cardiovascular diseases (CVD). This study aimed to investigate potential interactions between the RAAS, ADMA and MPO in cardiovascular risk patients. DESIGN AND METHODS: All in all, 1446 patients, who were referred to coronary angiography, were included in this prospective study...
March 18, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28321294/renin-angiotensin-aldosterone-system-altered-in-resistant-hypertension-in-sub-saharan-african-diabetes-patients-without-evidence-of-primary-hyperaldosteronism
#4
Bertille Elodie Edinga-Melenge, Vicky J Ama Moor, Jobert Richie N Nansseu, Romance Nguetse Djoumessi, Michel K Mengnjo, Jean-Claude Katte, Jean Jacques N Noubiap, Eugene Sobngwi
BACKGROUND: The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension. METHODS: We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28302238/gitelman-syndrome
#5
Qurat Ul Ain Mustafa, Zujaja Hina Haroon, Aamir Ijaz, Muhammad Tanveer Sajid, Muhammad Ayyub
Gitelman syndrome (GS) is the most frequently inherited renal salt-wasting tubulointerstitial disease. It follows variable but usually asymptomatic benign course. We present a rare case of GS that remained clinical enigma. A 22-year male presented with severe episodic fatigue involving all limbs associated with episodes of sinking, palpitations, salt craving, increased thirst and frequent micturition hampering his routine daily activities. Laboratory workup revealed serum potassium, 2.7 mmol/L, serum magnesium, 0...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28293914/a-late-diagnosis-of-primary-aldosteronism
#6
Francesco Zorzi, Oliviero Olivieri, Paolo Brazzarola, Francesca Pizzolo
We report the case of a 41-year-old male patient with juvenile onset refractory hypertension while taking four drugs including a diuretic. Fourteen years before he underwent a complete investigation for secondary hypertension (including the aldosterone to renin ratio-ARR) that was negative. Since that, hypertension control gradually worsened, hypertensive organ damage aggravated and hypokalemia developed in spite of ACE inhibitor treatment. At the re-evaluation ARR was elevated, and the further workup for primary aldosteronism demonstrated an unilateral aldosterone producing adenoma that was surgically removed, with subsequent optimal blood pressure control with two anti-hypertensive drugs...
March 14, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28289182/continuum-of-renin-independent-aldosteronism-in-normotension
#7
Rene Baudrand, Francisco J Guarda, Carlos Fardella, Gregory Hundemer, Jenifer Brown, Gordon Williams, Anand Vaidya
Primary aldosteronism is a severe form of autonomous aldosteronism. Milder forms of autonomous and renin-independent aldosteronism may be common, even in normotension. We characterized aldosterone secretion in 210 normotensives who had suppressed plasma renin activity (<1.0 ng/mL per hour), completed an oral sodium suppression test, received an infusion of angiotensin II, and had measurements of blood pressure and renal plasma flow. Continuous associations between urinary aldosterone excretion rate, renin, and potassium handling were investigated...
March 13, 2017: Hypertension
https://www.readbyqxmd.com/read/28186357/short-and-long-term-outcomes-with-renin-angiotensin-aldosterone-inhibitors-in-renal-transplant-recipients-a-meta-analysis-of-randomized-controlled-trials
#8
Ruo-Xi Liao, Xia-Fei Lyu, Wen-Jiao Tang, Kai Gao
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) are often prescribed for renal transplant recipients (RTRs), but the outcomes of these medications in RTRs remain controversial. METHODS: The PubMed, Embase, and Cochrane Library databases were systematically searched. Randomized controlled trials investigating the outcomes of ACEI/ARBs in RTRs were included for meta-analysis. RESULTS: Twenty-two trials with 2242 patients were identified...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28148579/liquorice-induced-apparent-mineralocorticoid-excess-presenting-in-the-emergency-department
#9
Stuart Declan Gallacher, Georgios Tsokolas, Ioannis Dimitropoulos
A 65-year-old woman with a background of myalgic encephalitis, who was taking alternative medicines and dietary supplements, presented with hypokalaemia and hypertension. After a thorough history it became apparent that this was most likely secondary to regular consumption of liquorice tea. The patient was advised to discontinue drinking this tea and was discharged. Follow-up showed normalising blood pressure and hypokalaemia, with a normal aldosterone:renin ratio.
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28129245/plasma-aldosterone-level-within-the-normal-range-is-less-associated-with-cardiovascular-and-cerebrovascular-risk-in-primary-aldosteronism
#10
Masahiko Murata, Tetsuhiro Kitamura, Daisuke Tamada, Kosuke Mukai, Shogo Kurebayashi, Tsunehiko Yamamoto, Kunihiko Hashimoto, Reiko D Hayashi, Haruhiko Kouhara, Sachi Takeiri, Yoshitaka Kajimoto, Makoto Nakao, Toshimitsu Hamasaki, Michio Otsuki, Iichiro Shimomura
BACKGROUND: Previous studies showed higher risk of cardiovascular and cerebrovascular (CCV) events in primary aldosteronism compared with essential hypertension, but the patients of these studies were limited to primary aldosteronism patients with high plasma aldosterone concentration (PAC). The introduction of the aldosterone-renin ratio as the screening test for primary aldosteronism led to the recognition of primary aldosteronism patients with normal PAC (nPA). However, there is no information on the risk of primary aldosteronism including nPA...
January 27, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28106020/renin-angiotensin-aldosterone-system-blockers-and-cardiovascular-outcomes-a-meta-analysis-of-randomized-clinical-trials
#11
Pınar Kızılırmak, Yağız Üresin, Oktay Özdemir, Burçak Kılıçkıran Avcı, Lale Tokgözoğlu, Zeki Öngen
OBJECTIVE: Hypertension is the most prevalent modifiable risk factor for cardiovascular (CV) and cerebrovascular morbidity and mortality. This study aimed to assess the effects of renin-angiotensin-aldosterone system (RAAS) blockade on CV outcomes. METHODS: This study was designed according to the Preferred Reporting Items for Systemic reviews and Meta-Analyses statement. Databases were searched for articles published as of December 2014. Two sets of studies were selected...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28102195/positive-association-between-kcnj5-rs2604204-a-c-polymorphism-and-plasma-aldosterone-levels-but-also-plasma-renin-and-angiotensin-i-and-ii-levels-in-newly-diagnosed-hypertensive-chinese-a-case-control-study
#12
H Wang, C Weng, H Chen
Variants in G protein-coupled inward rectifier K(+) channels 4 (GIRK4 also known as KCNJ5) gene are associated with primary aldosteronism, which is the most common cause of secondary hypertension. The KCNJ5 rs2604204 variant was shown to be common (minor allele frequency=32.5%) in Chinese patients with essential hypertension (EH). The relationship between KCNJ5 variant and plasma aldosterone (ALD) levels in EH patients has not been reported. We collected 229 patients with newly diagnosed EH without any antihypertensive agents...
January 19, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28069722/novel-approach-to-establishing-an-aldosterone-renin-ratio-cutoff-for-primary-aldosteronism
#13
Alexander A Leung, Dennis J Orton, Alex Chin, Hossein Sadrzadeh, Gregory A Kline
Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. In 2014, direct renin concentration replaced plasma renin activity in routine testing...
March 2017: Hypertension
https://www.readbyqxmd.com/read/27994942/effect-of-telmisartan-on-kidney-function-in-patients-with-chronic-kidney-disease-an-observational-study
#14
Ashish Agrawal, Shibnath Kamila, Swetha Reddy, Joyal Lilly, Ms Sadhguna Mariyala
Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Method: This was a prospective observational study. Fifty-six patients (>18 years) diagnosed with CKD were enrolled into the study...
2016: Journal of drug assessment
https://www.readbyqxmd.com/read/27965370/genetic-characterization-of-a-mouse-line-with-primary-aldosteronism
#15
L G Perez-Rivas, Y Rhayem, S Sabrautzki, C Hantel, B Rathkolb, M Hrabě de Angelis, M Reincke, F Beuschlein, A Spyroglou
In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism, a mutagenesis screen after treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. The steroidogenic enzyme expression levels in the adrenal gland did not differ significantly among phenotypically affected and unaffected mice...
February 2017: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/27932117/risk-factors-of-recurrence-of-diabetic-nephropathy-in-renal-transplants
#16
B Rodriguez Cubillo, B Rodriguez, M Calvo, V de la Manzanara, J Bautista, I Perez-Flores, N Calvo, A Moreno, A Shabaka, J Delgado, A I Sanchez-Fructuoso
BACKGROUND: Renal transplantation has been established as the treatment of choice for end-stage renal disease (ESRD) due to diabetic nephropathy. This study aimed to investigate the risk factors for recurrence of diabetic nephropathy (RDN) in renal allografts. METHODS: We studied 1,011 renal transplant patients from 1986 to 2003, of which 95 had ESRD due to diabetic nephropathy. We retrospectively analyzed the clinical characteristics and outcomes of RDN after renal transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27906842/spironolactone-and-the-risk-of-urinary-tract-cancer-in-patients-with-hypertension-a-nationwide-population-based-retrospective-case-control-study
#17
Ya-Wen Chuang, Mei-Ching Yu, Shih-Ting Huang, Cheng-Kuang Yang, Cheng-Hsu Chen, Ying-Chih Lo, Cheng-Li Lin, Kuo-Hsiung Shu, Tung-Min Yu, Chia-Hung Kao
AIM: This was a nationwide study by National Health Insurance Research Database to investigate the risk of urinary tract cancers (UTCs) for renin-angiotensin-aldosterone system inhibitors including spironolactone. METHODS: A total of 32 167 UTC patients with hypertension were enrolled in the National Health Insurance program between 2005 and 2011. RESULTS: Among different subclasses of renin-angiotensin-aldosterone system inhibitors, the adjusted odds ratio (OR) for UTC risk was 1...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27893293/prevelence-of-primary-aldosteronism-in-an-urban-hypertensive-population
#18
Sandi-Jo Galati, Khadeen C Cheesman, Ryan Springer-Miller, Sarah M Hopkins, Lawrence Krakoff, Emilia Bagiella, Rachel A Zhuk, Tiffany K Ying, Chelsey Amer, Michael K Boyajian, W B Inabnet, Alice C Levine
OBJECTIVE: To determine the prevalence of primary aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA. METHODS: An aldosterone:renin ratio (ARR, cutoff ≥20, with plasma aldosterone concentration [PAC] ≥10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (blood pressure [BP] ≥140/90) over the age of 18 from August 2012 through May 2013...
November 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27885499/the-effects-of-alpha-1-adrenoceptor-blockade-and-angiotensin-converting-enzyme-inhibition-on-central-and-brachial-blood-pressure-and-vascular-reactivity-the-doxazosin-ramipril-study
#19
Andreas Jekell, Majid Kalani, Thomas Kahan
We aimed to study whether inhibition of the renin-angiotensin-aldosterone system has effects on vascular structure and function beyond the effects on blood pressure reduction alone. Patients with mild-to-moderate hypertension (n = 61, age 54 ± 12 years, 34% women) received the angiotensin converting enzyme inhibitor ramipril 10 mg or the alpha 1-adrenoceptor blocker doxazosin 8 mg double-blind for 12 weeks. Aortic blood pressure, pulse wave velocity, and augmentation index were assessed by applanation tonometry...
November 24, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27867524/varying-effects-of-recommended-treatments-for-heart-failure-with-reduced-ejection-fraction-meta-analysis-of-randomized-controlled-trials-in-the-esc-and-accf-aha-guidelines
#20
REVIEW
Marius Mark Thomsen, Christian Lewinter, Lars Køber
The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included...
December 2016: ESC Heart Failure
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