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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/29212952/dysregulated-aldosterone-secretion-in-persons-of-african-descent-with-endothelin-1-gene-variants
#1
Jia W Tan, Tina Gupta, Worapaka Manosroi, Tham M Yao, Paul N Hopkins, Jonathan S Williams, Gail K Adler, Jose R Romero, Gordon H Williams
Compared with persons of European descent (ED), persons of African descent (AD) have lower aldosterone (ALDO) levels, with the assumption being that the increased cardiovascular disease (CVD) risk associated with AD is not related to ALDO. However, the appropriateness of the ALDO levels for the volume status in AD is unclear. We hypothesized that, even though ALDO levels are lower in AD, they are inappropriately increased, and therefore, ALDO could mediate the increased CVD in AD. To test this hypothesis, we analyzed data from HyperPATH - 1,788 individuals from the total cohort and 765 restricted to ED-to-AD in a 2:1 match and genotyped for the endothelin-1 gene (EDN1)...
December 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/29212491/case-report-schwannoma-arising-from-the-unilateral-adrenal-area-with-bilateral-hyperaldosteronism
#2
Naru Babaya, Yukako Makutani, Shinsuke Noso, Yoshihisa Hiromine, Hiroyuki Ito, Yasunori Taketomo, Kazuki Ueda, Hokuto Ushijima, Yoshifumi Komoike, Yuto Yamazaki, Hironobu Sasano, Yumiko Kawabata, Hiroshi Ikegami
BACKGROUND: We report a rare case of a juxta-adrenal schwannoma that could not be discriminated from an adrenal tumor before surgical resection and was complicated by bilateral hyperaldosteronism. To the best of our knowledge, this is first case in which both a juxta-adrenal schwannoma and hyperaldosteronism co-existed. CASE PRESENTATION: A 69-year-old male treated for hypertension was found to have a left supra-renal mass (5.8 × 5.2 cm) by abdominal computed tomography...
December 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29182374/lack-of-association-of-mirsnp-rs11174811-in-avpr1a-gene-with-arterial-blood-pressure-and-hypertension-in-south-indian-population
#3
Linda Koshy, S V Vijayalekshmi, S Harikrishnan, Kutty V Raman, V T Jissa, A Jayakumaran Nair, A Gangaprasad, G M Nair, P R Sudhakaran
Epigenetic regulation of arterial blood pressure mediated through mirSNPs in renin-angiotensin aldosterone system (RAAS) genes is a less explored hypothesis. Recently, the mirSNP rs11174811 in the 3'UTR of the AVPR1A gene was associated with higher arterial blood pressure in a large study population from the Study of Myocardial Infarctions Leiden (SMILE). The aim of the present study was to replicate the association of mirSNP rs11174811 with blood pressure outcomes and hypertension in a south Indian population...
November 28, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29145688/is-primary-aldosteronism-still-largely-unrecognized
#4
Fabrizio Buffolo, Silvia Monticone, Jacopo Burrello, Martina Tetti, Franco Veglio, Tracy Ann Williams, Paolo Mulatero
Primary aldosteronism (PA) was first reported by Jerome W. Conn in 1954 when it was considered a rare disorder, only suspected in cases of hypertension and spontaneous hypokalemia. Over the last 30 years, with the wide application of the plasma aldosterone to plasma renin activity ratio as screening test, the clinical spectrum of PA has dramatically changed. Different studies displayed significant differences in term of patients investigated, diagnostic criteria and hormonal assays; however, large prospective studies with robust diagnostic criteria indicated that the prevalence of PA is around 6% of the general hypertensive population and 11% of the patients referred to hypertension centers...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29141372/-role-of-adrenal-vein-sampling-in-differential-diagnosis-of-primary-aldosteronism-subtypes
#5
H Y Li, P Li, S M Shen, X B Zhang, W H Feng, H Huang, W Chen, D L Zhu
Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Bilaterally simultaneous catheterization without cosyntropin stimulation and contemporaneous cortisol measurement during AVS were used. Selectivity index (SI)≥1.5 suggested that the sample was from the adrenal vein...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29132172/can-screening-and-confirmatory-testing-in-the-management-of-patients-with-primary-aldosteronism-be-improved
#6
Michael Stowasser, Ashraf Ahmed, Zeng Guo, Martin Wolley, Jacobus Ungerer, Brett McWhinney, Marko Poglitsch, Richard Gordon
Widespread application of the plasma aldosterone/renin ratio (ARR) as a screening test has led to the recognition that primary aldosteronism (PA) is the most common specifically treatable and potentially curable form of hypertension, accounting for 5-10% of patients. Maximal detection requires accurate diagnostic approaches and awareness and control of factors that confound results, including most antihypertensives, posture, time of day, dietary salt, and plasma potassium. Recent studies have revealed potential for false positives in patients on beta-adrenoceptor blockers, and, when direct renin concentration (but not plasma renin activity) is used to measure renin, in women during the luteal phase of the menstrual cycle or receiving estrogen-containing contraceptives or hormonal replacement therapy...
November 13, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29129576/cardiometabolic-outcomes-and-mortality-in-medically-treated-primary-aldosteronism-a-retrospective-cohort-study
#7
Gregory L Hundemer, Gary C Curhan, Nicholas Yozamp, Molin Wang, Anand Vaidya
BACKGROUND: Mineralocorticoid receptor (MR) antagonists are the recommended medical therapy for primary aldosteronism. Whether this recommendation effectively reduces cardiometabolic risk is not well understood. We aimed to investigate the risk of incident cardiovascular events in patients with primary aldosteronism treated with MR antagonists compared with patients with essential hypertension. METHODS: We did a cohort study using patients from a research registry from Brigham and Women's Hospital, Massachusetts General Hospital, and their affiliated partner hospitals...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29115296/fully-automated-chemiluminescence-vs-ria-aldosterone-assay-in-primary-aldosteronism-work-up
#8
F Pizzolo, G Salvagno, B Caruso, C Cocco, F Zorzi, C Zaltron, A Castagna, L Bertolone, F Morandini, G Lippi, O Olivieri
Aldosterone and renin measurement is a cornerstone for primary aldosteronism (PA) diagnosis, but different thresholds are used according to different assays. A fully automated chemiluminescence (CL) immunoassay for renin and aldosterone was recently proposed, showing good performance for PA screening by aldosterone to renin ratio (ARR). This study aimed to define the accuracy of this assay in the screening and in the most popular confirmatory test of autonomous aldosterone production, the intravenous saline loading test (ivSLT)...
December 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29105958/additivity-of-nebivolol-valsartan-single-pill-combinations-versus-other-single-pill-combinations-for-hypertension
#9
Jack Ishak, Michael Rael, Henry Punzi, Alan Gradman, Lynn M Anderson, Mehul Patel, Sanjida Ali, William Ferguson, Joel Neutel
The single-pill combination (SPC) comprising nebivolol (5 mg), a vasodilatory β1 -selective antagonist/β3 -agonist, and valsartan (80 mg), a renin-angiotensin-aldosterone system inhibitor, is the only Food and Drug Administration-approved β-blocker/renin-angiotensin-aldosterone system inhibitor SPC for hypertension. Additive effects of four nebivolol/valsartan SPC doses (5 mg/80 mg, 5/160 mg, 10/160 mg, 10/320 mg nebivolol/valsartan) were compared with five Food and Drug Administration-approved non-β-blocker/renin-angiotensin-aldosterone system inhibitor SPCs (aliskiren/hydrochlorothiazide, aliskiren/amlodipine, valsartan/amlodipine, aliskiren/valsartan, and telmisartan/amlodipine)...
November 5, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29100412/the-therapeutic-effect-of-bromocriptine-in-combination-with-spironolactone-in-patients-with-primary-aldosteronism-a-hypothesis-generating-pilot-study
#10
Vin-Cent Wu, Che-Hsiung Wu, Ya-Wen Yang, Kuo-How Huang, Chia-Hui Chang, Shao-Yu Yang, Yen-Hung Lin, Kwan-Dun Wu
Background: Dopamine D2-like receptors are attenuated in aldosterone producing adenoma, lead to overproduction of aldosterone in affected patients, and thus reported to serve as a potential treatment target for primary aldosteronism. The D2 dopamine receptor agonist bromocriptine has been used clinically for reducing tumor mass of pituitary adenomas of lactotroph origin. The aim of the present study was to assess the efficacy of adding bromocriptine to spironolactone in the biochemical control of primary aldosteronism...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29093236/primary-hyperaldosteronism-due-to-adrenocortical-adenoma-a-case-report
#11
Tjokorda Gde Dalem Pemayun, Ridho Naibaho, Maretina W Wiyati, Ardy Santosa, Siti Amarwati
Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps  and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Her serum potassium level was always low that associated with inappropriate kaliuresis. Blood gas analysis revealed metabolic alkalosis. Sonography of the adrenal gland showed right hipoechoic architecture; CT scan of the abdomen confirmed an right adrenal tumor measured 4 cm in its greatest dimension...
July 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29070043/the-effect-of-renal-denervation-in-an-experimental-model-of-chronic-renal-insufficiency-the-remnant-kidney-denervation-in-pigs-study-redip-study
#12
Jean-Claude Lubanda, Miroslav Chochola, Mikuláš Mlček, Petr Neužil, Josef Marek, Štěpán Havránek, Sylvie Kuchynková, Zdeňka Fingrová, Kao-Hsuan Aimee Huang, Aleš Linhart
BACKGROUND: Renal denervation (RDN) is a promising therapeutic method in cardiology. Its currently most investigated indication is resistant hypertension. Other potential indications are atrial fibrillation, type 2 diabetes mellitus and chronic renal insufficiency among others. Previous trials showed conflicting but promising results, but the real benefits of RDN are still under investigation. Patients with renal insufficiency and resistant hypertension are proposed to be a good target for this therapy due to excessive activation of renal sympathetic drive...
October 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29059090/aldosterone-to-renin-ratio-depends-on-age-and-sex-in-children-attending-a-clinic-for-cardiovascular-risk-assessment
#13
Simonetta Genovesi, Laura Antolini, Antonina Orlando, Elena Tassistro, Marco Giussani, Elisa Nava, Lucia Turolo, Jenny Manolopoulou, Gianfranco Parati, Alberto Morganti
OBJECTIVE: To determine plasma aldosterone concentration (PAC) and plasma renin concentration (PRC) and aldosterone-to-renin ratio (ARR) values in a population attending a Clinic for Cardiovascular Risk Assessment in Children. METHODS: We assessed ARR and associated factors in a cohort of 287 children (137 female, 4-18 years). Weight and blood pressure (BP) were recorded. PAC (ng/dl) and PRC (mU/l) were measured using direct immunochemiluminescent assays. Data were examined by sex and according to four age classes...
October 20, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29022080/urinary-potassium-to-urinary-potassium-plus-sodium-ratio-can-accurately-identify-hypovolemia-in-nephrotic-syndrome-a-provisional-study
#14
Werner Keenswijk, Mohamad Ikram Ilias, Ann Raes, Raymond Donckerwolcke, Johan Vande Walle
There is evidence pointing to a decrease of the glomerular filtration rate (GFR) in a subgroup of nephrotic children, likely secondary to hypovolemia. The aim of this study is to validate the use of urinary potassium to the sum of potassium plus sodium ratio (UK/UK+UNa) as an indicator of hypovolemia in nephrotic syndrome, enabling detection of those patients who will benefit from albumin infusion. We prospectively studied 44 nephrotic children and compared different parameters to a control group (36 children)...
October 11, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28986076/association-between-obesity-and-risk-of-chronic-kidney-disease-a-nationwide-cohort-study-in-taiwan
#15
Y-J Lai, H-Y Hu, Y-L Lee, P-W Ku, Y-F Yen, D Chu
BACKGROUND AND AIMS: Increased body fat relates to enhanced inflammatory cytokine production, which, in turn, activates the renin-angiotensin-aldosterone system and increases the risk of chronic kidney disease (CKD). Herein, we aimed to examine the association between obesity and the risk of CKD in a population-representative cohort in Taiwan. METHODS AND RESULTS: A multistage systematic sampling process was applied in the National Health Interview Survey (NHIS) 2000, 2005, and 2009...
August 25, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28985347/systemic-angiotensinogen-concentrations-are-independently-associated-with-left-ventricular-diastolic-function-in-a-community-sample
#16
Aletta M E Millen, Angela J Woodiwiss, Monica Gomes, Frederic Michel, Gavin R Norton
Background: Left ventricular (LV) diastolic dysfunction characterizes heart failure with a preserved ejection fraction. Although it is recognized that the renin-angiotensin-aldosterone-system (RAAS) decreases LV diastolic function, whether systemic angiotensinogen contributes to these effects is uncertain. Hence the aim was to determine the relationship between systemic angiotensinogen concentrations and LV diastolic function. Methods: Left ventricular diastolic function was determined from the mean of the lateral and septal wall myocardial tissue lengthening at the mitral annulus (average e') and from the ratio of early transmitral blood flow velocity (E) to average e' (E/e') in 445 black African participants from a community sample...
August 18, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28985270/dietary-sodium-modifies-serum-uric-acid-concentrations-in-humans
#17
Alwyn S Todd, Robert J Walker, Robert J MacGinley, Jaimon Kelly, Tony R Merriman, Tanya J Major, Richard J Johnson
BACKGROUND: Subjects with hypertension are frequently obese or insulin resistant, both conditions in which hyperuricemia is common. Obese and insulin-resistant subjects are also known to have blood pressure that is more sensitive to changes in dietary sodium intake. Whether hyperuricemia is a resulting consequence, moderating or contributing factor to the development of hypertension has not been fully evaluated and very few studies have reported interactions between sodium intake and serum uric acid...
November 6, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28980289/heart-failure-with-recovered-ejection-fraction-clinical-characteristics-determinants-and-prognosis-cardiochus-chop-registry
#18
Rosa Agra Bermejo, Eva Gonzalez Babarro, J Nicolás López Canoa, Alfonso Varela Román, Inés Gómez Otero, Marcos Oro Ayude, Pablo Parada Vazquez, Isabel Gómez Rodríguez, Oscar Díaz Castro, Jose Ramón González Juanatey
BACKGROUND: The magnitude and the prognostic impact of recovering left ventricular ejection fraction (LVEF) in patients with heart failure (HF) and systolic dysfunction is unclear. The aim of this study was to evaluate the clinical characteristics and prognosis of patients with HFrecEF in an HF population. METHODS: 449 consecutive patients were selected with the diagnosis of HF and an evaluation of LVEF in the 6 months prior to selection who were referred to two HF units...
October 5, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28977886/combined-renin-angiotensin-aldosterone-system-blockade-and-statin-therapy-effectively-reduces-the-risk-of-cerebrovascular-accident-in-autosomal-dominant-polycystic-kidney-disease-a-nationwide-population-based-cohort-study
#19
Pei-Hsun Sung, Hsin-Ju Chiang, Mel S Lee, John Y Chiang, Hon-Kan Yip, Yao-Hsu Yang
Fairly limited data reported the incidence and risk of cerebrovascular accident (CVA) in autosomal dominant polycystic kidney disease (ADPKD). Additionally, little is known regarding the therapeutic impact of renin-angiotensin-aldosterone system (RAAS) blockade and statin on reducing the occurrence of CVA in ADPKD. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to perform a population-based cohort study (1997-2013). A total of 2,647 patients with ADPKD were selected from 1,000,000 general population after excluding patients with age<18, renal replacement therapy and concomitant diagnosis of CVA...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28958958/biological-diagnosis-of-primary-aldosteronism-summary-of-new-french-and-international-guidelines
#20
Damien Denimal, Stéphanie Lemaire, Laurence Duvillard
The biological diagnosis of primary aldosteronism (PA) is a real challenge in clinical laboratories. First, PA is a major cause of secondary hypertension, and more widespread screening is currently recommended. In addition, the recent development of automated and mass spectrometry tests has made it necessary to determine the most appropriate cutoff values in clinical studies. New French and international guidelines will play an important role in the standardization of PA diagnosis. The first diagnostic step is to measure the aldosterone to renin ratio (ARR), which is widely considered the best screening test...
October 1, 2017: Annales de Biologie Clinique
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