Key result
Feline systemic hypertension was associated with lower plasma renin activity and higher aldosterone, with renin activity increasing after amlodipine therapy.
Why the study?
Does amlodipine besylate alter plasma renin activity and aldosterone concentrations in hypertensive cats?
Observational (n=196)
Does amlodipine besylate alter plasma renin activity and aldosterone concentrations in hypertensive cats?
In hypertensive cats, plasma aldosterone is increased while renin activity is decreased, and treatment with amlodipine besylate increases renin activity without altering aldosterone levels.
Answers are grounded in this paper and cite their sources.
Suggests RAAS dysregulation in feline hypertension; hypothesis-generating for amlodipine effects on renin.
BACKGROUND: Role of renin-angiotensin aldosterone system (RAAS) in feline systemic hypertension is poorly understood. OBJECTIVES: Examine plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) in normotensive and hypertensive cats with variable renal function and in response to antihypertensive therapy. ANIMALS: One hundred and ninety-six cats >9 years from first opinion practice. METHODS: PRA, PAC, and aldosterone-to-renin ratio (ARR) were evaluated in cats recruited prospectively and grouped according to systolic blood pressure (SBP) and renal function (nonazotemic normotensive [Non-Azo-NT], nonazotemic hypertensive [Non-Azo-HT], azotemic normotensive [Azo-NT], azotemic hypertensive [Azo-HT]). Changes in PRA and PAC were evaluated with antihypertensive therapy (amlodipine besylate). RESULTS: Plasma renin activity (ng/mL/h; P = .0013), PAC (pg/mL; P < .001), and ARR (P = 0.0062) differed significantly among groups. PRA (ng/mL/h) was significantly lower in hypertensive (Non-Azo-HT; n = 25, median 0.22 [25th percentile 0.09, 75th percentile 0.39], Azo-HT; n = 44, 0.33 [0.15, 0.48]) compared with Non-Azo-NT cats (n = 57, 0.52 [0.28, 1.02]). Azo-HT cats had significantly higher PAC (n = 22, 149.8 [103.1, 228.7]) than normotensive cats (Non-Azo-NT; n = 26, 45.4 [19.6, 65.0], Azo-NT; n = 18, 84.1 [38.6, 137.8]). ARR was significantly higher in Azo-HT (n = 20, 503.8 [298.8, 1511]) than Azo-NT cats (n = 16, 97.8 [77.0, 496.4]). Significant increase in PRA was documented with antihypertensive therapy (pretreatment [n = 20] 0.32 [0.15-0.46], posttreatment 0.54 [0.28, 1.51]), but PAC did not change. CONCLUSIONS AND CLINICAL IMPORTANCE: Hypertensive cats demonstrate significantly increased PAC with decreased PRA. PRA significantly increases with antihypertensive therapy. Additional work is required to determine the role of plasma aldosterone concentration in the pathogenesis of hypertension and whether this relates to autonomous production or activation of RAAS without demonstrable increase in PRA.
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Jepson et al. (2013) conducted an observational in Systemic hypertension with and without azotemia (n=196). Amlodipine besylate vs. Pretreatment (baseline) and normotensive controls was evaluated on Plasma renin activity (PRA), plasma aldosterone concentrations (PAC), and aldosterone-to-renin ratio (ARR) (p=0.0013). Feline systemic hypertension was associated with lower plasma renin activity and higher aldosterone, with renin activity increasing after amlodipine therapy.
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