In patients at risk for primary aldosteronism, diuretics and vasodilators significantly influenced the aldosterone-to-renin ratio, while alpha-blockers and calcium channel blockers did not.
Observational (n=137)
No
How do antihypertensive drugs and electrolyte concentrations influence aldosterone and plasma renin activity in patients at risk for primary aldosteronism?
Introduction: Primary aldosteronism (PA) is a group of disorders which are characterized by inadequate and non-suppressible production of aldosterone. The prevalence of PA is increasing in hypertensive population. The golden standard of screening for primary aldosteronism, determination of aldosterone/plasma renin activity (ARR), is influenced by numerous exogenous and endogenous factors. Testing cannot always be conducted under optimal conditions. Objective: To determine influence of antihypertensive drugs and concentrations of potassium and sodium in blood and urine on values of aldosterone and plasma renin activity. Methods: In this retrospective study, we analyzed medical reports of patients admitted to Department of thyroid gland disease in the period from 2009 to 2011, with increased risk for primary aldosteronism. Body weight and height, sodium and potassium in serum and urine, plasma aldosterone concentrations and plasma renin activity, data on medicines and comorbidity were analyzed in all patients. In processing data, statistical methods descriptive analysis, Student T test and univariate linear regression were applied. Result: Of 137 patients, there were more patients with resistant hypertension (53,28%) than with adrenal tumors (46,72%). Most patients used calcium channel blockers. Treatment with alpha blockers and calcium channel blockers does not influence ARR. Beta blockers and ACE inhibitors can influence ARR and diuretics and vasodilatators have definite influence. Diabetes mellitus can have higher risk of false negative results. Urine sodium excretion is significantly correlated with plasma aldosteron and serum potassium. Plasma aldosteron and PRA are significantly correlated with concentrations of electrolites in urine. Conclusion: Increased prevalence of primary aldosteronism necessitates need for accurate and better diagnostics.
Tijana Lalić (Tue,) conducted a observational in Increased risk for primary aldosteronism (resistant hypertension, adrenal tumors) (n=137). Antihypertensive therapy (various classes), sodium intake, and potassium concentration vs. Patients not receiving the specific therapy was evaluated on Influence on aldosterone concentration, plasma renin activity (PRA), and aldosterone-to-renin ratio (ARR). In patients at risk for primary aldosteronism, diuretics and vasodilators significantly influenced the aldosterone-to-renin ratio, while alpha-blockers and calcium channel blockers did not.