Effect of moxonidine on the aldosterone/renin ratio in healthy male volunteers

Ahmed, Ashraf H., Gordon, Richard D., Ward, Gregory, Wolley, Martin, McWhinney, Brett C., Ungerer, Jacobus P. and Stowasser, Michael (2017) Effect of moxonidine on the aldosterone/renin ratio in healthy male volunteers. Journal of Clinical Endocrinology & Metabolism, 102 6: 2039-2043. doi:10.1210/jc.2016-3821


Author Ahmed, Ashraf H.
Gordon, Richard D.
Ward, Gregory
Wolley, Martin
McWhinney, Brett C.
Ungerer, Jacobus P.
Stowasser, Michael
Title Effect of moxonidine on the aldosterone/renin ratio in healthy male volunteers
Journal name Journal of Clinical Endocrinology & Metabolism   Check publisher's open access policy
ISSN 1945-7197
0021-972X
Publication date 2017-06-01
Year available 2017
Sub-type Article (original research)
DOI 10.1210/jc.2016-3821
Open Access Status Not yet assessed
Volume 102
Issue 6
Start page 2039
End page 2043
Total pages 5
Place of publication Cary, NC, United States
Publisher Oxford University Press
Language eng
Subject 2712 Endocrinology, Diabetes and Metabolism
1303 Biochemistry
1310 Endocrinology
1308 Clinical Biochemistry
2704 Biochemistry, medical
Abstract Background: The most popular screening test for primary aldosteronism is the plasma aldosterone/ renin ratio (ARR). Medications, dietary sodium, posture, and time of day all affect renin and aldosterone levels and can result in false-negative or false-positive ARRs if not controlled. Most antihypertensive medications affect the ARR and can interfere with interpretation of results. To our knowledge, no study has been undertaken to evaluate the effects of moxonidine on the ARR. Methods: Normotensive, nonmedicated male volunteers (n = 20) underwent measurement (seated, midmorning) of plasma aldosterone (by high-performance liquid chromatography-tandem mass spectrometry), direct renin concentration (DRC), plasma renin activity (PRA), cortisol, electrolytes and creatinine; and urinary aldosterone, cortisol, electrolytes and creatinine at baseline and after 1 week of moxonidine at 0.2 mg/d and a further 5 weeks at 0.4 mg/d. Results: Compared with baseline, despite the expected significant falls in both systolic and diastolic blood pressure, levels of plasma aldosterone [median, 134 (range, 90 to 535) pmol/L], DRC [20 (10 to 37) mU/L], PRA [2.2 (1.0-3.8) ng/mL/h], and ARR using either DRC [8.0 (4.4 to 14.4)] or PRA [73 (36 to 218)] were not significantly changed after either 1 [135 (98-550) pmol/L, 20 (11-35) mU/L, 2.0 (1.2-4.1) ng/mL/h, 8.8 (4.2 to 15.9), and 73 (32-194), respectively] or 6 weeks [130 (90-500) pmol/L, 22 (8 to 40) mU/L, 2.1 (1.0 to 3.2) ng/mL/h, 7.7 (4.3 to 22.4), and 84 (32 to 192), respectively] of moxonidine. There were no changes in any urinary measurements. Conclusion: Moxonidine was associated with no significant change in the ARR and may therefore be a good option for maintaining control of hypertension when screening for primary aldosteronism.
Formatted abstract
Background: The most popular screening test for primary aldosteronism is the plasma aldosterone/ renin ratio (ARR). Medications, dietary sodium, posture, and time of day all affect renin and aldosterone levels and can result in false-negative or false-positive ARRs if not controlled. Most antihypertensive medications affect the ARR and can interfere with interpretation of results. To our knowledge, no study has been undertaken to evaluate the effects of moxonidine on the ARR.

Methods: Normotensive, nonmedicated male volunteers (n = 20) underwent measurement (seated, midmorning) of plasma aldosterone (by high-performance liquid chromatography-tandem mass spectrometry), direct renin concentration (DRC), plasma renin activity (PRA), cortisol, electrolytes and creatinine; and urinary aldosterone, cortisol, electrolytes and creatinine at baseline and after 1 week of moxonidine at 0.2 mg/d and a further 5 weeks at 0.4 mg/d.

Results: Compared with baseline, despite the expected significant falls in both systolic and diastolic blood pressure, levels of plasma aldosterone [median, 134 (range, 90 to 535) pmol/L], DRC [20 (10 to 37) mU/L], PRA [2.2 (1.0-3.8) ng/mL/h], and ARR using either DRC [8.0 (4.4 to 14.4)] or PRA [73 (36 to 218)] were not significantly changed after either 1 [135 (98-550) pmol/L, 20 (11-35) mU/L, 2.0 (1.2-4.1) ng/mL/h, 8.8 (4.2 to 15.9), and 73 (32-194), respectively] or 6 weeks [130 (90-500) pmol/L, 22 (8 to 40) mU/L, 2.1 (1.0 to 3.2) ng/mL/h, 7.7 (4.3 to 22.4), and 84 (32 to 192), respectively] of moxonidine. There were no changes in any urinary measurements.

Conclusion: Moxonidine was associated with no significant change in the ARR and may therefore be a good option for maintaining control of hypertension when screening for primary aldosteronism.
Keyword Tandem Mass-Spectrometry
Renin-Activity
Essential-Hypertension
Menstrual-Cycle
Diagnosis
Plasma
Hyperaldosteronism
Management
Disease
Kidney
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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