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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/29442523/patterns-of-heart-failure-symptoms-are-associated-with-self-care-behaviors-over-6-months
#1
Jonathan P Auld, James O Mudd, Jill M Gelow, Karen S Lyons, Shirin O Hiatt, Christopher S Lee
BACKGROUND: Both heart failure symptoms and self-care are associated with patient outcomes. Although it is thought that symptoms drive self-care, there is limited evidence to support this assumption over time. AIMS: To determine whether patterns of physical symptoms are significantly associated with heart failure self-care over time. METHOD: Latent mixture analysis was used to identify subgroups based on physical symptoms of dyspnea, sleepiness and edema (using the heart failure somatic perception and Epworth sleepiness scales)...
February 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29382124/effect-of-melatonin-on-the-renin-angiotensin-aldosterone-system-in-l-name-induced-hypertension
#2
Fedor Simko, Tomas Baka, Kristina Krajcirovicova, Kristina Repova, Silvia Aziriova, Stefan Zorad, Marko Poglitsch, Michaela Adamcova, Russel J Reiter, Ludovit Paulis
The renin-angiotensin-aldosterone system (RAAS) is a dominant player in several cardiovascular pathologies. This study investigated whether alterations induced by l-NAME, (NLG)-nitro-l-arginine methyl ester, a nitric oxide synthase inhibitor, and the protective effect of melatonin are associated with changes in the RAAS. Four groups of 3-month-old male Wistar rats (n = 10) were treated as follows for four weeks: untreated controls, rats treated with melatonin (10 mg/kg/day), rats treated with l-NAME (40 mg/kg/day), and rats treated with l-NAME + melatonin...
January 29, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29344922/impact-of-renin-angiotensin-aldosterone-system-polymorphisms-on-myocardial-perfusion-correlations-with-myocardial-single-photon-emission-computed-tomography-derived-parameters
#3
George Angelidis, Maria Samara, Maria Papathanassiou, Maria Satra, Varvara Valotassiou, Ioannis Tsougos, Dimitrios Psimadas, Chara Tzavara, Sotiria Alexiou, John Koutsikos, Nikolaos Demakopoulos, Gregory Giamouzis, Filippos Triposkiadis, John Skoularigis, Panagoula Kollia, Panagiotis Georgoulias
BACKGROUND: Renin-angiotensin-aldosterone system (RAAS) has an important role in atherosclerosis. We investigated the effects of six RAAS gene polymorphisms on myocardial perfusion. METHODS AND RESULTS: We examined 810 patients with known or suspected coronary artery disease (CAD) using stress-rest myocardial single-photon emission computed tomography. Summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), transient ischemic dilation (TID), and lung/heart ratio (LHR) were recorded...
January 17, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29335324/prevalence-of-primary-aldosteronism-in-primary-care-a-cross-sectional-study
#4
Sabine C Käyser, Jaap Deinum, Wim Jc de Grauw, Bianca Wm Schalk, Hans Jhj Bor, Jacques Wm Lenders, Tjard R Schermer, Marion Cj Biermans
BACKGROUND: Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. Reported prevalences of PA vary considerably because of a large heterogeneity in study methodology. AIM: To examine the proportion of patients with PA among patients with newly diagnosed, never treated hypertension. DESIGN AND SETTING: A cross-sectional study set in primary care. METHOD: GPs measured aldosterone and renin in adult patients with newly diagnosed, never treated hypertension...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29327797/potassium-and-the-use-of-renin-angiotensin-aldosterone-system-inhibitors-in-heart-failure-with-reduced-ejection-fraction-data-from-biostat-chf
#5
Joost C Beusekamp, Jasper Tromp, Haye H van der Wal, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Pim van der Harst, Hans L Hillege, Chim C Lang, Marco Metra, Leong L Ng, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Aeilko H Zwinderman, Patrick Rossignol, Faiez Zannad, Adriaan A Voors, Peter van der Meer
BACKGROUND: Hyperkalaemia is a common co-morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Whether it affects the use of renin-angiotensin-aldosterone system inhibitors and thereby negatively impacts outcome is unknown. Therefore, we investigated the association between potassium and uptitration of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and its association with outcome. METHODS AND RESULTS: Out of 2516 patients from the BIOSTAT-CHF study, potassium levels were available in 1666 patients with HFrEF...
January 12, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29322198/association-of-cardiovascular-biomarkers-with-incident-heart-failure-with-preserved-and-reduced-ejection-fraction
#6
Rudolf A de Boer, Matthew Nayor, Christopher R deFilippi, Danielle Enserro, Vijeta Bhambhani, Jorge R Kizer, Michael J Blaha, Frank P Brouwers, Mary Cushman, Joao A C Lima, Hossein Bahrami, Pim van der Harst, Thomas J Wang, Ron T Gansevoort, Caroline S Fox, Hanna K Gaggin, Willem J Kop, Kiang Liu, Ramachandran S Vasan, Bruce M Psaty, Douglas S Lee, Hans L Hillege, Traci M Bartz, Emelia J Benjamin, Cheeling Chan, Matthew Allison, Julius M Gardin, James L Januzzi, Sanjiv J Shah, Daniel Levy, David M Herrington, Martin G Larson, Wiek H van Gilst, John S Gottdiener, Alain G Bertoni, Jennifer E Ho
Importance: Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF) as opposed to reduced ejection fraction (HFrEF), yet associations of biomarkers with future heart failure subtype are incompletely understood. Objective: To evaluate the associations of 12 cardiovascular biomarkers with incident HFpEF vs HFrEF among adults from the general population. Design, Setting, and Participants: This study included 4 longitudinal community-based cohorts: the Cardiovascular Health Study (1989-1990; 1992-1993 for supplemental African-American cohort), the Framingham Heart Study (1995-1998), the Multi-Ethnic Study of Atherosclerosis (2000-2002), and the Prevention of Renal and Vascular End-stage Disease study (1997-1998)...
January 10, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29305116/urine-albumin-is-a-superior-predictor-of-preeclampsia-compared-to-urine-plasminogen-in-type-i-diabetes-patients
#7
Lise Hald Nielsen, Boye L Jensen, Jens Fuglsang, Lise Lotte Torvin Andersen, Dorte Møller Jensen, Jan Stener Jørgensen, Gitte Kitlen, Per Ovesen
Pregnant women with type I diabetes mellitus (T1DM) are at increased risk of developing preeclampsia (PE). Plasminogen is aberrantly filtrated from plasma into tubular fluid in PE patients and activated to plasmin. Plasmin activates the epithelial sodium channel in the collecting ducts potentially causing impaired sodium excretion, suppression of the renin-angiotensin-aldosterone system, and hypertension in PE. The objective of the study was to test whether urinary total plasmin(ogen)/creatinine ratio and plasma concentration of aldosterone were better predictors of PE in pregnant women with T1DM compared with urine albumin and haemoglobin A1C...
December 13, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29279269/renin-angiotensin-aldosterone-system-raas-blockers-usage-among-type-ii-diabetes-mellitus-patients-a-retrospective-study
#8
Yen Ping Ng, Ganesh Pandian Balasubramanian, Yi Ping Heng, Meera Kalaiselvan, Yu Wen Teh, Kin Man Cheong, Muhammad Faiz Bin Abdul Hadi, Rosmaliza Bt Othman
AIMS: Recent data showed an alarming rise of new dialysis cases secondary to diabetic nephropathy despite the growing usage of RAAS blockers. Primary objective of this study is to explore the prevalence of RAAS blockers usage among type II diabetic patients, secondary objectives are to compare the prescribing pattern of RAAS blocker between primary and tertiary care center and to explore if the dose of RAAS blocker prescribed was at optimal dose as suggested by trials. MATERIALS AND METHODS: This is a retrospective study conducted at one public tertiary referral hospital and one public health clinic in Sungai Petani, Kedah, Malaysia...
December 21, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29277469/the-seisicat-study-a-pilot-study-assessing-efficacy-and-safety-of-spironolactone-in-cats-with-congestive-heart-failure-secondary-to-cardiomyopathy
#9
Rachel James, Emilie Guillot, Catherine Garelli-Paar, Jacqueline Huxley, Vanessa Grassi, Malcolm Cobb
INTRODUCTION: The pathophysiology of heart failure involves activation of several neurohormonal systems including the renin-angiotensin-aldosterone system. The mineralocorticoid receptor antagonist spironolactone has been shown to be beneficial in humans and dogs with heart failure. The objective of this pilot study was to investigate the efficacy and safety of spironolactone in cats with heart failure secondary to cardiomyopathy already treated with furosemide and an angiotensin-converting enzyme inhibitor...
December 22, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29275380/double-hit-a-unique-case-of-resistant-hypertension
#10
Kristen Elizabeth DeCarlo, Nidhi Agrawal
A middle-aged woman with obesity, hyperlipidaemia and diet-controlled diabetes was referred for resistant hypertension. Her blood pressure (BP) was uncontrolled on five medications, including a diuretic. Physical exam revealed a systolic ejection murmur, and ECHO demonstrated moderate hypertrophy. Laboratory examination revealed elevated aldosterone level (20.7 ng/dL) and elevated aldosterone:renin ratio (41.4 (ng/dL)/(ng/mL/h)), meeting criteria for primary aldosteronism (PA), and confirmed by saline infusion testing...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29249599/analysis-of-postoperative-biochemical-values-and-clinical-outcomes-after-adrenalectomy-for-primary-aldosteronism
#11
Andrew J Swearingen, Bora Kahramangil, Rosebel Monteiro, Vikram Krishnamurthy, Judy Jin, Joyce Shin, Allan Siperstein, Eren Berber
BACKGROUND: Primary aldosteronism causes hypertension and hypokalemia and is often surgically treatable. Diagnosis includes elevated plasma aldosterone, suppressed plasma renin activity, and elevated aldosterone renin ratio. Adrenalectomy improves hypertension and hypokalemia. Postoperative plasma aldosterone and plasma renin activity may be useful in documenting cure or failure. METHOD: A retrospective analysis of patients who underwent adrenalectomy for primary aldosteronism from 2010 to 2016 was performed, analyzing preoperative and postoperative plasma aldosterone, plasma renin activity, hypertension, and hypokalemia...
December 14, 2017: Surgery
https://www.readbyqxmd.com/read/29238437/persistent-primary-aldosteronism-despite-iatrogenic-adrenal-hemorrhage-after-adrenal-vein-sampling
#12
Keisuke Okamura, Tetsu Okuda, Kazuyuki Shirai, Ichiro Abe, Kunihisa Kobayashi, Tatsu Ishii, Seiji Haraoka, Hidenori Urata
Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage...
January 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29237382/renin-activity-and-aldosterone-assay-among-nigerians-with-hypertension-and-normotension-an-insight-into-normative-values-and-clinical-correlates
#13
Adeseye Abiodun Akintunde, Afolabi Salawu, Boluwatife Adeniyi
OBJECTIVES: Plasma renin activity (PRA) and aldosterone tend to differ between Blacks and Caucasians and studies are very scarce among Africans. We therefore aimed to determine the normative value of plasma renin activity and serum aldosterone among school teachers in Nigeria with normal blood pressure compared with their hypertensive counterparts and relevant clinical/demographic associations. METHODS: Plasma renin activity and serum aldosterone were measured using the kits provided by Diagnostic Biochem, Canada among randomly selected school teachers recruited as part of a study to assess their total cardiovascular risks...
December 13, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29212952/dysregulated-aldosterone-secretion-in-persons-of-african-descent-with-endothelin-1-gene-variants
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
December 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
#20
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
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