schliessen

Filtern

 

Bibliotheken

Are Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?

Aldosterone/renin ratios fluctuate during the menstrual cycle; avoiding the luteal phase during screening premenopausal women for primary aldosteronism may minimize the risk of false positives. Background: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curabl... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2011, Vol.96 (2), p.E340-E346
Main Author: Ahmed, Ashraf H
Other Authors: Gordon, Richard D , Taylor, Paul J , Ward, Gregory , Pimenta, Eduardo , Stowasser, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/20962019
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_850561106
title: Are Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?
format: Article
creator:
  • Ahmed, Ashraf H
  • Gordon, Richard D
  • Taylor, Paul J
  • Ward, Gregory
  • Pimenta, Eduardo
  • Stowasser, Michael
subjects:
  • Abridged Index Medicus
  • Adult
  • Aldosterone - blood
  • Chromatography, High Pressure Liquid
  • False Positive Reactions
  • Female
  • Follicle Stimulating Hormone - blood
  • Humans
  • Hydrocortisone - blood
  • Hyperaldosteronism - diagnosis
  • Immunoassay
  • Male
  • Menstrual Cycle - metabolism
  • Mineralocorticoid Receptor Antagonists
  • Progesterone - blood
  • Renin - blood
  • Sex Characteristics
  • Tandem Mass Spectrometry
ispartof: The journal of clinical endocrinology and metabolism, 2011, Vol.96 (2), p.E340-E346
description: Aldosterone/renin ratios fluctuate during the menstrual cycle; avoiding the luteal phase during screening premenopausal women for primary aldosteronism may minimize the risk of false positives. Background: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.5404196
LOCALfalse
PrimoNMBib
record
control
sourceidproquest_cross
recordidTN_cdi_proquest_miscellaneous_850561106
sourceformatXML
sourcesystemPC
sourcerecordid850561106
originalsourceidFETCH-LOGICAL-1382t-28e4ca55689a619c87bee9d6e9d9e8564f271159907b1b25777ca34695f6d0370
addsrcrecordideNp1kM9PHCEYhknTpq62t54bbr04FpgBhlOzMfVHYqOpmvZGWOYbyzoDW2BM_O_LuOrB1APhOzzvC9-D0CdKDiij5OvaHjBCSUVrzt-gBVUNryRV8i1aEMJopST7vYN2U1oTQpuG1-_RDiNKlJBaoLtlBPwrjODxj1BGk_FPl25x6PGRGRJUFyG57O4AX0Q3mniPl0MXUoYYvEsjvrQRwDt_g43v8LX3YCGlmbucNptYZhc8voKUZyb_MeUd8N8-oHf9XP_x8d5D10ffrw5PqrPz49PD5VnZpmW5Yi001nAuWmUEVbaVKwDViXIUtFw0PZOUcqWIXNEV41JKa-pGKN6LjtSS7KEv295NDH-n8gs9umRhGIyHMCXdcsIFpUQUcn9L2hhSitDrzXZhTYmeReu11bNoPYsu-OfH4mk1QvcMP5ktAHvRZ102udjI0bjhtdZ6GwLfBRudhweFeh2m6Iun_6f-AfJymnc
sourcetypeAggregation Database
isCDItrue
recordtypearticle
pqid850561106
display
typearticle
titleAre Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?
creatorAhmed, Ashraf H ; Gordon, Richard D ; Taylor, Paul J ; Ward, Gregory ; Pimenta, Eduardo ; Stowasser, Michael
creatorcontribAhmed, Ashraf H ; Gordon, Richard D ; Taylor, Paul J ; Ward, Gregory ; Pimenta, Eduardo ; Stowasser, Michael
descriptionAldosterone/renin ratios fluctuate during the menstrual cycle; avoiding the luteal phase during screening premenopausal women for primary aldosteronism may minimize the risk of false positives. Background: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.
identifier
0ISSN: 0021-972X
1EISSN: 1945-7197
2DOI: 10.1210/jc.2010-1355
3PMID: 20962019
languageeng
publisherUnited States: Endocrine Society
subjectAbridged Index Medicus ; Adult ; Aldosterone - blood ; Chromatography, High Pressure Liquid ; False Positive Reactions ; Female ; Follicle Stimulating Hormone - blood ; Humans ; Hydrocortisone - blood ; Hyperaldosteronism - diagnosis ; Immunoassay ; Male ; Menstrual Cycle - metabolism ; Mineralocorticoid Receptor Antagonists ; Progesterone - blood ; Renin - blood ; Sex Characteristics ; Tandem Mass Spectrometry
ispartofThe journal of clinical endocrinology and metabolism, 2011, Vol.96 (2), p.E340-E346
rightsCopyright © 2011 by The Endocrine Society
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-1382t-28e4ca55689a619c87bee9d6e9d9e8564f271159907b1b25777ca34695f6d0370
links
openurl$$Topenurl_article
thumbnail$$Usyndetics_thumb_exl
backlink$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20962019$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Ahmed, Ashraf H
1Gordon, Richard D
2Taylor, Paul J
3Ward, Gregory
4Pimenta, Eduardo
5Stowasser, Michael
title
0Are Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?
1The journal of clinical endocrinology and metabolism
addtitleJ Clin Endocrinol Metab
descriptionAldosterone/renin ratios fluctuate during the menstrual cycle; avoiding the luteal phase during screening premenopausal women for primary aldosteronism may minimize the risk of false positives. Background: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.
subject
0Abridged Index Medicus
1Adult
2Aldosterone - blood
3Chromatography, High Pressure Liquid
4False Positive Reactions
5Female
6Follicle Stimulating Hormone - blood
7Humans
8Hydrocortisone - blood
9Hyperaldosteronism - diagnosis
10Immunoassay
11Male
12Menstrual Cycle - metabolism
13Mineralocorticoid Receptor Antagonists
14Progesterone - blood
15Renin - blood
16Sex Characteristics
17Tandem Mass Spectrometry
issn
00021-972X
11945-7197
fulltextfalse
rsrctypearticle
creationdate2011
recordtypearticle
recordideNp1kM9PHCEYhknTpq62t54bbr04FpgBhlOzMfVHYqOpmvZGWOYbyzoDW2BM_O_LuOrB1APhOzzvC9-D0CdKDiij5OvaHjBCSUVrzt-gBVUNryRV8i1aEMJopST7vYN2U1oTQpuG1-_RDiNKlJBaoLtlBPwrjODxj1BGk_FPl25x6PGRGRJUFyG57O4AX0Q3mniPl0MXUoYYvEsjvrQRwDt_g43v8LX3YCGlmbucNptYZhc8voKUZyb_MeUd8N8-oHf9XP_x8d5D10ffrw5PqrPz49PD5VnZpmW5Yi001nAuWmUEVbaVKwDViXIUtFw0PZOUcqWIXNEV41JKa-pGKN6LjtSS7KEv295NDH-n8gs9umRhGIyHMCXdcsIFpUQUcn9L2hhSitDrzXZhTYmeReu11bNoPYsu-OfH4mk1QvcMP5ktAHvRZ102udjI0bjhtdZ6GwLfBRudhweFeh2m6Iun_6f-AfJymnc
startdate201102
enddate201102
creator
0Ahmed, Ashraf H
1Gordon, Richard D
2Taylor, Paul J
3Ward, Gregory
4Pimenta, Eduardo
5Stowasser, Michael
generalEndocrine Society
scope
0CGR
1CUY
2CVF
3ECM
4EIF
5NPM
6AAYXX
7CITATION
87X8
sort
creationdate201102
titleAre Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?
authorAhmed, Ashraf H ; Gordon, Richard D ; Taylor, Paul J ; Ward, Gregory ; Pimenta, Eduardo ; Stowasser, Michael
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-1382t-28e4ca55689a619c87bee9d6e9d9e8564f271159907b1b25777ca34695f6d0370
rsrctypearticles
prefilterarticles
languageeng
creationdate2011
topic
0Abridged Index Medicus
1Adult
2Aldosterone - blood
3Chromatography, High Pressure Liquid
4False Positive Reactions
5Female
6Follicle Stimulating Hormone - blood
7Humans
8Hydrocortisone - blood
9Hyperaldosteronism - diagnosis
10Immunoassay
11Male
12Menstrual Cycle - metabolism
13Mineralocorticoid Receptor Antagonists
14Progesterone - blood
15Renin - blood
16Sex Characteristics
17Tandem Mass Spectrometry
toplevelpeer_reviewed
creatorcontrib
0Ahmed, Ashraf H
1Gordon, Richard D
2Taylor, Paul J
3Ward, Gregory
4Pimenta, Eduardo
5Stowasser, Michael
collection
0Medline
1MEDLINE
2MEDLINE (Ovid)
3MEDLINE
4MEDLINE
5PubMed
6CrossRef
7MEDLINE - Academic
jtitleThe journal of clinical endocrinology and metabolism
delivery
delcategoryRemote Search Resource
fulltextno_fulltext
addata
au
0Ahmed, Ashraf H
1Gordon, Richard D
2Taylor, Paul J
3Ward, Gregory
4Pimenta, Eduardo
5Stowasser, Michael
formatjournal
genrearticle
ristypeJOUR
atitleAre Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?
jtitleThe journal of clinical endocrinology and metabolism
addtitleJ Clin Endocrinol Metab
date2011-02
risdate2011
volume96
issue2
spageE340
epageE346
pagesE340-E346
issn0021-972X
eissn1945-7197
abstractAldosterone/renin ratios fluctuate during the menstrual cycle; avoiding the luteal phase during screening premenopausal women for primary aldosteronism may minimize the risk of false positives. Background: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.
copUnited States
pubEndocrine Society
pmid20962019
doi10.1210/jc.2010-1355
oafree_for_read