Document Detail


The prevalence of a raised aldosterone-renin ratio (ARR) among new referrals to a hypertension clinic.
MedLine Citation:
PMID:  16864158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The wider application of the plasma aldosterone to renin activity ratio (ARR) test has led independent groups to report a 10-fold or higher prevalence in the detection and prevalence of primary aldosteronism than previously suggested, although such figures have been contested. We determined the prevalence of a raised ARR in an unselected group of patients who were referred to the hypertension clinic at Aberdeen Royal Infirmary. Over a 4-month period, all newly referred patients had an ARR, urea and electrolytes, and 24-h ambulatory blood pressure monitoring (ABPM) performed in addition to a detailed clinical examination. One hundred and twenty-two patients (mean age 51 +/- 16 years) were examined over the study period; 57 (47%) were receiving no anti-hypertensive medication, 32(26% of total) had a normal 24-h ABPM of which 15 patients were receiving antihypertensive medication ("controlled" hypertensives) and 17(14%) were receiving no anti-hypertensive medication ("white-coat hypertensives). Twenty patients (mean age 58 +/- 11 years) were found to have a raised ARR (> 750), of which 10 patients were receiving beta-blocker therapy as part of their anti-hypertensive regimen. Patients with a raised ARR were more likely (odds ratio 3.6, 95% confidence interval 1.2-13.2, p < 0.05) to be classified as a "non-dipper" compared with those whose blood pressure fell at night. The proportion of newly referred hypertensive patients with a raised ARR is still significant and confirms that of previous studies The ratio appears to be significantly driven by a suppressed renin value and further investigation is required to clarify the status of those patients receiving anti-hypertensive medications, particularly beta-blockers.
Authors:
D Williams; B Croal; J Furnace; S Ross; K Witte; M Webster; W Critchen; J Webster
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood pressure     Volume:  15     ISSN:  0803-7051     ISO Abbreviation:  Blood Press.     Publication Date:  2006  
Date Detail:
Created Date:  2006-07-25     Completed Date:  2006-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  164-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacology, Aberdeen Royal Infirmary, Aberdeen, UK. David.J.Williams@arh.grampian.scot.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aldosterone / blood*
Ambulatory Care Facilities
Antihypertensive Agents / therapeutic use
Blood Pressure Monitoring, Ambulatory
Female
Humans
Hypertension / blood*,  drug therapy
Male
Middle Aged
Prevalence
Referral and Consultation
Renin / blood*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 52-39-1/Aldosterone; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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