Effect of atenolol on aldosterone/renin ratio calculated by both plasma renin activity and direct renin concentration in healthy male volunteers

Ahmed, Ashraf H., Gordon, Richard D., Taylor, Paul, Ward, Gregory, Pimenta, Eduardo and Stowasser, Michael (2010) Effect of atenolol on aldosterone/renin ratio calculated by both plasma renin activity and direct renin concentration in healthy male volunteers. Journal of Clinical Endocrinology and Metabolism, 95 7: 3201-3206. doi:10.1210/jc.2010-0225


Author Ahmed, Ashraf H.
Gordon, Richard D.
Taylor, Paul
Ward, Gregory
Pimenta, Eduardo
Stowasser, Michael
Title Effect of atenolol on aldosterone/renin ratio calculated by both plasma renin activity and direct renin concentration in healthy male volunteers
Journal name Journal of Clinical Endocrinology and Metabolism   Check publisher's open access policy
ISSN 0021-972X
1945-7197
0096-7173
0368-1610
Publication date 2010-07
Sub-type Article (original research)
DOI 10.1210/jc.2010-0225
Volume 95
Issue 7
Start page 3201
End page 3206
Total pages 6
Editor Leonard Wartofsky
Place of publication Bethesda, MD, U.S.A.
Publisher Endocrine Society
Collection year 2011
Language eng
Formatted abstract
Background: The most popular screening test for primary aldosteronism (PAL) is the plasma aldosterone to renin ratio (ARR). Medications, dietary sodium, posture, and time of day all affect renin and aldosterone levels and can result in false-negative or -positive ARR if not controlled. Opinions are divided on whether β-adrenoreceptor blockers significantly affect the ARR.

Methods: Normotensive, nonmedicated male volunteers (n = 21) underwent measurement (seated, midmorning) of plasma aldosterone (by HPLC-tandem mass spectrometry), direct renin concentration (DRC), renin activity (PRA), cortisol, electrolytes, and creatinine and urinary aldosterone, cortisol, electrolytes, and creatinine at baseline, and after 1 wk (25 mg daily) and 4 wk (50 mg daily for three additional weeks) of atenolol.

Results: Compared with baseline, levels of aldosterone, DRC, and PRA were lower (P < 0.001) after both 1 and 4 wk [median (25–75th percentiles): baseline, 189 (138–357) pmol/liter, 40 (30–46) mU/liter, and 4.6 (2.7–5.8) ng/ml · h; 1 wk, 166 (112–310) pmol/liter, 34 (30–40) mU/liter, and 2.6 (2.0–3.1) ng/ml · h; 4 wk, 136 (97–269) pmol/liter, 16 (13–23) mU/liter, and 2.1(1.7–2.6) ng/ml · h, respectively]. ARR was significantly higher after 1 wk compared with baseline when calculated using PRA [61 (30–73) vs. 65 (44–130), P < 0.01] but not DRC [5 (4–7) vs. 5 (4–8)]. At 4 wk, ARR calculated by both PRA [78 (49–125)] and DRC [8 (6–14)] were significantly higher (P < 0.001) compared with baseline, and cortisol levels were significantly lower [92 (68–100) vs. 66 (48–91) ng/ml, P < 0.01]. There were no changes in plasma sodium, potassium, creatinine, or any urinary measurements.

Conclusion: β-Blockers can significantly raise the ARR and thereby increase the risk of false positives during screening for PAL.
Copyright © 2010 by The Endocrine Society
Keyword Tandem mass-spectrometry
Hypertensive patients
Menstrual-cycle
Diagnosis
Prevalence
Hyperaldosteronism
Blockade
Axis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 25 Jul 2010, 00:05:44 EST