A study on aldosterone to renin ratio as a predictor of antihypertensive efficacy of spironolactone
Dr Rushil Donga
, Dr Yatin Prajapati , Dr Utsav Patel , Dr Arpit Goel , Dr R K Samar
aldosterone/renin ratio, hypertension, primary aldosteronism, spironolactone
Abstract : Aim - Aldosterone/renin ratio is an index for inappropriate aldosterone activity, and it is increasingly being used to screen for primary aldosteronism within the hypertensive population. This ratio can also be useful in predicting the effectiveness of spironolactone treatment for hypertension in patients with primary aldosteronism, which is characterized by excessive aldosterone production. To determine the impact of oral spironolactone on blood pressure in hypertensive patients with primary aldosteronism identified by an elevated aldosterone/renin ratio. Method - A prospective cohort study was done of hypertensive patients with raised aldosterone/renin ratio, who failed to suppress plasma aldosterone with salt loading and fludrocortisone suppression test. spironolactone treatment was given and were followed-up for a period of up to 3 years. Result - In this study, 28 participants (12 male) with an average age of 55 years (standard deviation of 10) were followed for an average of 12.9 months (standard deviation of 7). At the start of the study, the patients were taking an average of 2.1 (standard deviation of 1.2) antihypertensive drugs, but 16 out of 28 (57%) still had a diastolic blood pressure greater than 90 mmHg and 39% had a systolic blood pressure greater than 160 mmHg. After starting spironolactone treatment, three patients reported breast tenderness but continued treatment and one patient was unable to tolerate the medication and had to stop treatment. Of the remaining 27 patients, the average number of antihypertensive drugs taken decreased to spironolactone plus 0.7 (standard deviation of 0.9). All but one patient (96%) had a diastolic blood pressure less than or equal to 90 mmHg, and 78% had a systolic blood pressure less than or equal to 160 mmHg. A total of 48% had a blood pressure less than or equal to 140/90 mmHg, and 13 out of 27 (48%) were treated with spironolactone monotherapy. When only considering patients who were taking medication at the start of the study (n=24), spironolactone significantly reduced the number of antihypertensive drugs needed by 0.5 (confidence interval of 0.1 to 1.0, p=0.02) and also significantly reduced both systolic blood pressure by 15 mmHg (confidence interval of 5 to 25, p=0.007) and diastolic blood pressure by 8 mmHg (confidence interval of 4 to 13, p=0.001). Conclusion - This study found that spironolactone was an effective treatment for hypertension in patients with high aldosterone/renin ratios. Since an elevated ratio is a strong indicator of primary aldosteronism, characterized by excessive aldosterone production, it may be worthwhile for hypertensive patients with high aldosterone/renin ratios to use spironolactone, as long as they have been ruled out for adrenal adenomas through imaging methods.
"A study on aldosterone to renin ratio as a predictor of antihypertensive efficacy of spironolactone", IJSDR - International Journal of Scientific Development and Research (www.IJSDR.org), ISSN:2455-2631, Vol.8, Issue 1, page no.268 - 270, January-2023, Available :https://ijsdr.org/papers/IJSDR2301043.pdf
Volume 8
Issue 1,
January-2023
Pages : 268 - 270
Paper Reg. ID: IJSDR_203412
Published Paper Id: IJSDR2301043
Downloads: 000347254
Research Area: Medical Science
Country: Udaipur, Rajasthan, India
ISSN: 2455-2631 | IMPACT FACTOR: 9.15 Calculated By Google Scholar | ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.15 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
Publisher: IJSDR(IJ Publication) Janvi Wave
