Is the phase of the menstrual cycle important when screening for primary aldosteronism (PAL) in women, and does renin assay method matter?

Ahmed, A. H., Gordon, R. D., Taylor, P., Ward, G. and Stowasser, M. (2010). Is the phase of the menstrual cycle important when screening for primary aldosteronism (PAL) in women, and does renin assay method matter?. In: John E. Hall, Hypertension. Abstracts from the 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia. HBPRCA 2009 ASM: 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia, Sydney, NSW, Australia, (1494-1494). 1-3 December 2009. doi:10.1161/HYP.0b013e3181df4279


Author Ahmed, A. H.
Gordon, R. D.
Taylor, P.
Ward, G.
Stowasser, M.
Title of paper Is the phase of the menstrual cycle important when screening for primary aldosteronism (PAL) in women, and does renin assay method matter?
Conference name HBPRCA 2009 ASM: 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia
Conference location Sydney, NSW, Australia
Conference dates 1-3 December 2009
Proceedings title Hypertension. Abstracts from the 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia   Check publisher's open access policy
Journal name Hypertension   Check publisher's open access policy
Place of Publication Baltimore, MD, U.S.A.
Publisher Lippincott Williams & Wilkins for the American Heart Association
Publication Year 2010
Year available 2009
DOI 10.1161/HYP.0b013e3181df4279
ISSN 0194-911X
1524-4563
0073-425X
Editor John E. Hall
Volume 55
Issue 6
Start page 1494
End page 1494
Total pages 1
Language eng
Formatted Abstract/Summary
The most popular screening test for PAL is the plasma aldosterone (aldo)/renin ratio (ARR). Medications, dietary Na+, posture and time of day all affect renin and aldo levels, and can result in false −ve or +ve ARRs if not controlled. Because fluctuations in both estrogen [E2, raises renin substrate but direct renin concentration (DRC) falls to prevent increases in angiotensin (A-II)] and progesterone (prog, aldo-antagonist) affect aldo and renin levels, we studied effects of phases of the menstrual cycle on ARR, measuring renin as both DRC and plasma renin activity (PRA, a better surrogate for A-II).

Conclusion: Both renin and aldo levels increase in the luteal phase, presumably due to prog antagonizing aldo action. A smaller rise in DRC (due to negative feedback of A-II) than in PRA results in even higher ARR with risk of false positives. Premenopausal women should be screened for PAL during the follicular phase.
Subjects 1103 Clinical Sciences
Q-Index Code EX
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published as Abstract 007.

Document type: Conference Paper
Collections: Non HERDC
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Created: Sun, 29 Aug 2010, 00:05:42 EST