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The Effects of Verapamil, Hydralazine, and Doxazosin on Renin, Aldosterone, and the Ratio Thereof
- Source :
- Cardiovascular Drugs and Therapy, 37(2), 283-289. Kluwer Academic Publishers
- Publication Year :
- 2023
- Publisher :
- Kluwer Academic Publishers, 2023.
-
Abstract
- Purpose Hydralazine, doxazosin, and verapamil are currently recommended by the Endocrine Society as acceptable bridging treatment in those in whom full cessation of antihypertensive medication is infeasible during screening for primary aldosteronism (PA). This is under the assumption that they cause minimal to no effect on the aldosterone-to-renin ratio, the most widely used screening test for PA. However, limited evidence is available regarding the effects of these particular drugs on said ratio. Methods In the present study, we retrospectively assessed the changes in aldosterone, renin, and aldosterone-to-renin values in essential hypertensive participants before and after treatment with either hydralazine (n = 26) or doxazosin (n = 20) or verapamil (n = 15). All samples were taken under highly standardized conditions. Results Hydralazine resulted in a borderline significant rise in active plasma renin concentration (19 vs 25 mIU/L, p = 0.067) and a significant fall in the aldosterone-to-renin ratio (38 vs 24, p = 0.017). Doxazosin caused declines in both plasma aldosterone concentration (470 vs 330 pmol/L, p = 0.028) and the aldosterone-to-renin ratio (30 vs 20, p = 0.020). With respect to verapamil, we found no statistically significant effect on any of these outcome variables. Conclusion We conclude that the assumption that these drugs can be used with little consequence to the aldosterone-to-renin cannot be substantiated. While it is possible that they are indeed the best option when full antihypertensive drug cessation is infeasible, the potential effects of these drugs must still be taken into account when interpreting the aldosterone-to-renin ratio.
- Subjects :
- medicine.medical_specialty
PHARMACOKINETICS
medicine.drug_class
Urology
VASOPRESSIN
NIFEDIPINE
Essential hypertension
Plasma renin activity
CALCIUM
chemistry.chemical_compound
DOUBLE-BLIND
Primary aldosteronism
Renin-aldosterone ratio
medicine
Doxazosin
Pharmacology (medical)
ESSENTIAL-HYPERTENSION
Antihypertensive drug
Pharmacology
Aldosterone
business.industry
VASODILATORS
General Medicine
Hydralazine
medicine.disease
chemistry
Verapamil
SECRETION
Cardiology and Cardiovascular Medicine
business
ANGIOTENSIN-ALDOSTERONE
medicine.drug
DILTIAZEM
Subjects
Details
- Language :
- English
- ISSN :
- 09203206
- Volume :
- 37
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Cardiovascular Drugs and Therapy
- Accession number :
- edsair.doi.dedup.....566e433629619413083bf17f14b7d8a9