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Effect of Moxonidine on the Aldosterone/Renin Ratio in Healthy Male Volunteers

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 an... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2017-06, Vol.102 (6), p.2039-2043
Main Author: Ahmed, Ashraf H
Other Authors: Gordon, Richard D , Ward, Gregory , Wolley, Martin , McWhinney, Brett C , Ungerer, Jacobus P , Stowasser, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Washington, DC: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28324033
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recordid: cdi_proquest_miscellaneous_1880084800
title: Effect of Moxonidine on the Aldosterone/Renin Ratio in Healthy Male Volunteers
format: Article
creator:
  • Ahmed, Ashraf H
  • Gordon, Richard D
  • Ward, Gregory
  • Wolley, Martin
  • McWhinney, Brett C
  • Ungerer, Jacobus P
  • Stowasser, Michael
subjects:
  • Abridged Index Medicus
  • Adrenal glands
  • Adult
  • Aldosterone
  • Aldosterone - metabolism
  • Antihypertensive Agents - pharmacology
  • Antihypertensives
  • Blood pressure
  • Blood Pressure - drug effects
  • Chromatography, High Pressure Liquid
  • Creatinine
  • Creatinine - metabolism
  • Diet
  • Electrolytes
  • Healthy Volunteers
  • High performance liquid chromatography
  • Humans
  • Hydrocortisone
  • Hydrocortisone - metabolism
  • Hypertension
  • Imidazoles - pharmacology
  • Liquid chromatography
  • Male
  • Males
  • Mass spectrometry
  • Mass spectroscopy
  • Plasma
  • Posture
  • Potassium - metabolism
  • Renin
  • Renin - drug effects
  • Renin - metabolism
  • Sodium
  • Sodium - metabolism
  • Tandem Mass Spectrometry
ispartof: The journal of clinical endocrinology and metabolism, 2017-06, Vol.102 (6), p.2039-2043
description: 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. In a group of 20 males, moxonidine had no effect on the plasma aldosterone/renin ratio and may therefore be a good option for maintaining hypertension when screening for primary aldosteronism.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleEffect of Moxonidine on the Aldosterone/Renin Ratio in Healthy Male Volunteers
creatorAhmed, Ashraf H ; Gordon, Richard D ; Ward, Gregory ; Wolley, Martin ; McWhinney, Brett C ; Ungerer, Jacobus P ; Stowasser, Michael
creatorcontribAhmed, Ashraf H ; Gordon, Richard D ; Ward, Gregory ; Wolley, Martin ; McWhinney, Brett C ; Ungerer, Jacobus P ; Stowasser, Michael
descriptionAbstract 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. In a group of 20 males, moxonidine had no effect on the plasma aldosterone/renin ratio and may therefore be a good option for maintaining hypertension when screening for primary aldosteronism.
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subjectAbridged Index Medicus ; Adrenal glands ; Adult ; Aldosterone ; Aldosterone - metabolism ; Antihypertensive Agents - pharmacology ; Antihypertensives ; Blood pressure ; Blood Pressure - drug effects ; Chromatography, High Pressure Liquid ; Creatinine ; Creatinine - metabolism ; Diet ; Electrolytes ; Healthy Volunteers ; High performance liquid chromatography ; Humans ; Hydrocortisone ; Hydrocortisone - metabolism ; Hypertension ; Imidazoles - pharmacology ; Liquid chromatography ; Male ; Males ; Mass spectrometry ; Mass spectroscopy ; Plasma ; Posture ; Potassium - metabolism ; Renin ; Renin - drug effects ; Renin - metabolism ; Sodium ; Sodium - metabolism ; Tandem Mass Spectrometry
ispartofThe journal of clinical endocrinology and metabolism, 2017-06, Vol.102 (6), p.2039-2043
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descriptionAbstract 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. In a group of 20 males, moxonidine had no effect on the plasma aldosterone/renin ratio and may therefore be a good option for maintaining hypertension when screening for primary aldosteronism.
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0Abridged Index Medicus
1Adrenal glands
2Adult
3Aldosterone
4Aldosterone - metabolism
5Antihypertensive Agents - pharmacology
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7Blood pressure
8Blood Pressure - drug effects
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10Creatinine
11Creatinine - metabolism
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15High performance liquid chromatography
16Humans
17Hydrocortisone
18Hydrocortisone - metabolism
19Hypertension
20Imidazoles - pharmacology
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22Male
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24Mass spectrometry
25Mass spectroscopy
26Plasma
27Posture
28Potassium - metabolism
29Renin
30Renin - drug effects
31Renin - metabolism
32Sodium
33Sodium - metabolism
34Tandem Mass Spectrometry
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titleEffect of Moxonidine on the Aldosterone/Renin Ratio in Healthy Male Volunteers
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abstractAbstract 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. In a group of 20 males, moxonidine had no effect on the plasma aldosterone/renin ratio and may therefore be a good option for maintaining hypertension when screening for primary aldosteronism.
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pubEndocrine Society
pmid28324033
doi10.1210/jc.2016-3821
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