The Effects of Verapamil, Hydralazine, and Doxazosin on Renin, Aldosterone, and the Ratio Thereof
| Autor: | Abraham A. Kroon, Gregory P Veldhuizen, Rawan M Alnazer, Peter W. de Leeuw |
|---|---|
| Přispěvatelé: | RS: CARIM School for Cardiovascular Diseases, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, MUMC+: MA Alg Interne Geneeskunde (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
PHARMACOKINETICS medicine.drug_class Urology VASOPRESSIN NIFEDIPINE Essential hypertension Plasma renin activity CALCIUM chemistry.chemical_compound DOUBLE-BLIND Primary aldosteronism Renin-aldosterone ratio medicine Doxazosin Pharmacology (medical) ESSENTIAL-HYPERTENSION Antihypertensive drug Pharmacology Aldosterone business.industry VASODILATORS General Medicine Hydralazine medicine.disease chemistry Verapamil SECRETION Cardiology and Cardiovascular Medicine business ANGIOTENSIN-ALDOSTERONE medicine.drug DILTIAZEM |
| Zdroj: | Cardiovascular Drugs and Therapy, 37(2), 283-289. Kluwer Academic Publishers |
| ISSN: | 0920-3206 |
| Popis: | Purpose Hydralazine, doxazosin, and verapamil are currently recommended by the Endocrine Society as acceptable bridging treatment in those in whom full cessation of antihypertensive medication is infeasible during screening for primary aldosteronism (PA). This is under the assumption that they cause minimal to no effect on the aldosterone-to-renin ratio, the most widely used screening test for PA. However, limited evidence is available regarding the effects of these particular drugs on said ratio. Methods In the present study, we retrospectively assessed the changes in aldosterone, renin, and aldosterone-to-renin values in essential hypertensive participants before and after treatment with either hydralazine (n = 26) or doxazosin (n = 20) or verapamil (n = 15). All samples were taken under highly standardized conditions. Results Hydralazine resulted in a borderline significant rise in active plasma renin concentration (19 vs 25 mIU/L, p = 0.067) and a significant fall in the aldosterone-to-renin ratio (38 vs 24, p = 0.017). Doxazosin caused declines in both plasma aldosterone concentration (470 vs 330 pmol/L, p = 0.028) and the aldosterone-to-renin ratio (30 vs 20, p = 0.020). With respect to verapamil, we found no statistically significant effect on any of these outcome variables. Conclusion We conclude that the assumption that these drugs can be used with little consequence to the aldosterone-to-renin cannot be substantiated. While it is possible that they are indeed the best option when full antihypertensive drug cessation is infeasible, the potential effects of these drugs must still be taken into account when interpreting the aldosterone-to-renin ratio. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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