Effects of Ramipril on the Aldosterone/Renin Ratio and the Aldosterone/Angiotensin II Ratio in Patients With Primary Aldosteronism
| Autor: | Diane Cowley, Brett McWhinney, Oliver Domenig, Michael Stowasser, Marko Poglitsch, Zeng Guo, Martin Wolley, Jacobus P.J. Ungerer |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Ramipril medicine.medical_specialty Aldosterone renin Adolescent Angiotensin-Converting Enzyme Inhibitors 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Plasma renin activity Renin-Angiotensin System Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Primary aldosteronism Internal medicine Hyperaldosteronism Renin Renin–angiotensin system Internal Medicine medicine Humans In patient Aldosterone Aged business.industry Angiotensin II Middle Aged medicine.disease Treatment Outcome Endocrinology chemistry Female business medicine.drug |
| Zdroj: | Hypertension. 76:488-496 |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/hypertensionaha.120.14871 |
| Popis: | The aldosterone/renin ratio (ARR) is currently considered the most reliable approach for case detection of primary aldosteronism (PA). ACE (Angiotensin-converting enzyme) inhibitors are known to raise renin and lower aldosterone levels, thereby causing false-negative ARR results. Because ACE inhibitors lower angiotensin II levels, we hypothesized that the aldosterone/equilibrium angiotensin II (eqAngII) ratio (AA2R) would remain elevated in PA. Receiver operating characteristic curve analysis involving 60 patients with PA and 40 patients without PA revealed that the AA2R was not inferior to the ARR in screening for PA. When using liquid chromatography-tandem mass spectrometry to measure plasma aldosterone concentration, the predicted optimal AA2R cutoff for PA screening was 8.3 (pmol/L)/(pmol/L). We then compared the diagnostic performance of the AA2R with the ARR among 25 patients with PA administered ramipril (5 mg/day) for 2 weeks. Compared with basally, plasma levels of equilibrium angiotensin I (eqAngI) and direct renin concentration increased significantly ( P P P |
| Databáze: | OpenAIRE |
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