Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pilz, S; Trummer, C; Verheyen, N; Schwetz, V; Pandis, M; Aberer, F; Grübler, MR; Meinitzer, A; Bachmann, A; Voelkl, J; Alesutan, I; Catena, C; Sechi, LA; März, W; Obermayer-Pietsch, B; Tomaschitz, A.
Mineralocorticoid Receptor Blockers and Aldosterone to Renin Ratio: A Randomized Controlled Trial and Observational Data.
Horm Metab Res. 2018; 50(5):375-382
Doi: 10.1055/a-0604-3249
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- Führende Autor*innen der Med Uni Graz
- Pilz Stefan
- Co-Autor*innen der Med Uni Graz
- Aberer Felix
- Grübler Martin
- März Winfried
- Meinitzer Andreas
- Obermayer-Pietsch Barbara
- Pandis Marlene
- Theiler-Schwetz Verena
- Tomaschitz Andreas
- Trummer Christian
- Verheyen Nicolas Dominik
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- Abstract:
- Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT). Patients were 1:1 randomly assigned to receive either 25 mg eplerenone once daily (up-titration after 4 weeks to 50 mg/day) or placebo for 8 weeks. Second, we measured the ARR in 4 PA patients from the Graz Endocrine Causes of Hypertension Study (GECOH) before and after MR blocker treatment. Ninety-seven participants completed the EPATH trial, and the mean treatment effect (95% confidence interval) for log(e)ARR was 0.08 (-0.32 to 0.48) ng/dl/μU/ml (p=0.694). The treatment effect was 0.71 (0.47 to 0.96; p<0.001) ng/dl for log(e)PAC and 0.64 (0.19 to 1.10; p=0.006) μU/ml for log(e)DRC, respectively. In the 4 PA patients, the ARR decreased from 11.24±3.58 at baseline to 2.70±1.03 (p=0.013) ng/dl/μU/ml after MR blocker treatment. In this study with limited sample size, MR blocker treatment did not significantly alter the ARR in pHPT patients but significantly reduced the ARR in PA patients. Diagnostic utility of ARR and its components for PA diagnostics under MR blocker treatment warrants further study. © Georg Thieme Verlag KG Stuttgart · New York.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aldosterone - blood
- Double-Blind Method -
- Eplerenone -
- Female -
- Humans -
- Hyperaldosteronism - blood
- Hyperaldosteronism - drug therapy
- Hyperparathyroidism - blood
- Hyperparathyroidism - drug therapy
- Male -
- Middle Aged -
- Mineralocorticoid Receptor Antagonists - administration & dosage
- Mineralocorticoid Receptor Antagonists - adverse effects
- Renin - blood
- Spironolactone - administration & dosage
- Spironolactone - adverse effects
- Spironolactone - analogs & derivatives
- Time Factors -
- Find related publications in this database (Keywords)
- eplerenone
- spironolactone
- ARR
- RCT
- placebo