Guest guest Posted May 6, 2008 Report Share Posted May 6, 2008 I have an appointment to see my family doctor this afternoon. I'm hoping he will have my renin / aldo results - the hospital did not have them back two weeks ago. Of course the lab wanted the tests taken 12 weeks ago to be redone - they were repeated 4 weeks ago so maybe it is a bit soon to have them back. I'm told that if the ratio is greater than 800 that is diagnostic of PA, between 400 and 800 is inconclusive and less than 400 is a negative result. Is this correct? My blood pressure is running about 156/108 when seated, rested first thing in the morning (about 5 am). Helen in Scotland Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2008 Report Share Posted May 6, 2008 Urge you to take my article to your Dr. Note the 4 stages would apply to recurrence as well. 1. Physiological Hyperaldo- Renin low, aldo normal for you. 2. Personal Hyperaldo-Renin low, aldo high for you. 3. Group Hyperaldo-Renin low, aldo high for lab averages 4. Classical Hyperaldo-the full blown symptoms. On May 6, 2008, at 6:15 AM, Helen wrote: > I have an appointment to see my family doctor this afternoon. I'm > hoping he will have my renin / aldo results - the hospital did not > have > them back two weeks ago. Of course the lab wanted the tests taken 12 > weeks ago to be redone - they were repeated 4 weeks ago so maybe it is > a bit soon to have them back. > > I'm told that if the ratio is greater than 800 that is diagnostic of > PA, between 400 and 800 is inconclusive and less than 400 is a > negative > result. Is this correct? My blood pressure is running about 156/108 > when seated, rested first thing in the morning (about 5 am). > > Helen in Scotland Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2008 Report Share Posted May 7, 2008 The Dr has had several copies of your article. It gets filed. My BP was 182/124 at 4.30 pm - much the same numbers as I get at home at that time of day. As my weight has come down my BP has risen. I am still overweight - when I gain more than a couple of pounds my BP drops...... I find this very strange. Aldo 168 renin 2 so no PA K is 6.0 (high) Sodium just below normal lower level (no numbers given) Thyroid function is fine. Kidney function is good. I feel exhausted but with everything that is happening riht now I suppose that isn't so surprising. I've been asked to try 2mg of doxazosin a day. I haven't taken it yet as I'm a bit scared after reading the possible side effects. I may not take it until Saturday when at least I will have some back up if things go wrong although there will be no senior staff member on duty at the local hospital over the weekend. I suppose they would take me to Edinburgh if they had to.... Helen in Scotland > > Urge you to take my article to your Dr. Note the 4 stages would > apply to recurrence as well. > > 1. Physiological Hyperaldo- Renin low, aldo normal for you. > 2. Personal Hyperaldo-Renin low, aldo high for you. > 3. Group Hyperaldo-Renin low, aldo high for lab averages > 4. Classical Hyperaldo-the full blown symptoms. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2008 Report Share Posted May 7, 2008 Need to know what the normal values are for that lab renin and aldo to make a better interpetation. If no PA this seems like a very high aldo but units of the assay are key to know. Increases with slight weight gain suggests either weight sensitive BP or Salt sensitive BP or both. Keep working on it. My approach would be to use difficult HTN approach outlines in my file. But you may have failed many of these. On May 7, 2008, at 6:03 AM, Helen wrote: > The Dr has had several copies of your article. It gets filed. > > My BP was 182/124 at 4.30 pm - much the same numbers as I get at home > at that time of day. As my weight has come down my BP has risen. I am > still overweight - when I gain more than a couple of pounds my BP > drops...... I find this very strange. > > Aldo 168 renin 2 so no PA > > K is 6.0 (high) > Sodium just below normal lower level (no numbers given) > > Thyroid function is fine. > > Kidney function is good. > > I feel exhausted but with everything that is happening riht now I > suppose that isn't so surprising. > > I've been asked to try 2mg of doxazosin a day. I haven't taken it yet > as I'm a bit scared after reading the possible side effects. I may > not take it until Saturday when at least I will have some back up if > things go wrong although there will be no senior staff member on duty > at the local hospital over the weekend. I suppose they would take me > to Edinburgh if they had to.... > > Helen in Scotland > > > > > > Urge you to take my article to your Dr. Note the 4 stages would > > apply to recurrence as well. > > > > 1. Physiological Hyperaldo- Renin low, aldo normal for you. > > 2. Personal Hyperaldo-Renin low, aldo high for you. > > 3. Group Hyperaldo-Renin low, aldo high for lab averages > > 4. Classical Hyperaldo-the full blown symptoms. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2008 Report Share Posted May 7, 2008 The aldo was 168 pmol/L (lab norn 55-388) so pretty much mid range. I'm not sure about the renin - all I was given were the results and told the aldo was fine and the renin on the high side. My U & E shows sodium just below lab normal and potassium above lab normal. Helen in Scotland > > > > > > Urge you to take my article to your Dr. Note the 4 stages would > > > apply to recurrence as well. > > > > > > 1. Physiological Hyperaldo- Renin low, aldo normal for you. > > > 2. Personal Hyperaldo-Renin low, aldo high for you. > > > 3. Group Hyperaldo-Renin low, aldo high for lab averages > > > 4. Classical Hyperaldo-the full blown symptoms. > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2008 Report Share Posted May 7, 2008 I am alergic to both Lotrel and Bisoprolol - as the hospital found out when trying the emergency lowering of BP! I ended up in ICU. I had an SJS reaction to Bisoprolol and lost part of my sight. I do not want to go down that route again...... Lotrel made my BP rise up above 300/150 - they say I was lucky to come out of that at all. I think that is why we are now going to try doxazosin. I think almost everything has been tried and at best there is no effect and at worst I end up in ICU. Maybe the high uncontrolled BP is something I just have to accept. I know I am just about out of options. Helen in Scotland > > Need to know what the normal values are for that lab renin and aldo > to make a better interpetation. > > If no PA this seems like a very high aldo but units of the assay are > key to know. > > Increases with slight weight gain suggests either weight sensitive BP > or Salt sensitive BP or both. > > Keep working on it. > > My approach would be to use difficult HTN approach outlines in my > file. But you may have failed many of these. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2008 Report Share Posted May 7, 2008 Assuming the renin is not low it would appear that you do not have recurrent PA but 24 hr urine aldo is better but maybe not is Scotland. If renin is not low and you were not dehydrated or on a low sodium diet then tested then again you do not likely have recurrent PA. Good news. Still does not explain HTN either. Have you bee tried on spiro since surgery? I would prob do another trial but high K is worrysome. We have discussed measurement of K problems in Scotland before. Are the BP ones you get a home or only at Dr. If at home has your BP device been calibrated against a mercury device in last year. The same question should be asked in the Drs office. A major report from England a few years ago stressed that a Drs office that does not have a regular BP calibration program in effect is guilty of medical negligence. On May 7, 2008, at 12:53 PM, Helen wrote: > The aldo was 168 pmol/L (lab norn 55-388) so pretty much mid range. > > I'm not sure about the renin - all I was given were the results and > told the aldo was fine and the renin on the high side. > > My U & E shows sodium just below lab normal and potassium above lab > normal. > > Helen in Scotland > > > > > > > > > > Urge you to take my article to your Dr. Note the 4 stages would > > > > apply to recurrence as well. > > > > > > > > 1. Physiological Hyperaldo- Renin low, aldo normal for you. > > > > 2. Personal Hyperaldo-Renin low, aldo high for you. > > > > 3. Group Hyperaldo-Renin low, aldo high for lab averages > > > > 4. Classical Hyperaldo-the full blown symptoms. > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2008 Report Share Posted May 8, 2008 I am on a low sodium diet - proved by the lower than range blood sodium. I was told this would not invalidate the aldo / renin test. I was not dehydrated - I don't always manage the 3 litres a day the haemo suggests but definately drink more than 2.5 litres of water a day. I was unable to continue with spiro due to the side effects back in 2002. That is why I opted for surgery. The last K check is probably okay as the reults were back from the lab with 15 minutes. It was done as a special at the same time as the blood was drawn for aldo/renin so we would be as sure as possible the reading was correct. The reading at home and at the Dr's surgery are within a couple of points of each other. My machine was checked against the pharmacy supply store's calibration machine 6 weeks ago. the DR's mercury machine has a label on it that says it was checked and passed 2 weeks ago. I am glad it does not look like PA again but I would like to know what is causing the high BP. If I knew what was causing it maybe it would be easier to treat / cure. As it is I feel like I am floundering around in the dark. Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2008 Report Share Posted May 9, 2008 Dont know how they tried Lotrel on you I always start with 1/2 the lowest dose the then work up. Never had it increase BP. Maybe when it was stopped and a re bound occured. There are still some old timers that may not have been tried. Apresoline, reserpine, guanethidine I (and others )have even done bilateral adrenalectomies in cases like yours but would want to see pathology on side taken out and more detailed testing of RAAS. Surely would try Inspra first. Anyway let me know which city is closest to you and I will see who I can find at the HTN meeting that might know someone in the area. On May 7, 2008, at 1:08 PM, Helen wrote: > I am alergic to both Lotrel and Bisoprolol - as the hospital found > out when trying the emergency lowering of BP! I ended up in ICU. > > I had an SJS reaction to Bisoprolol and lost part of my sight. I do > not want to go down that route again...... Lotrel made my BP rise up > above 300/150 - they say I was lucky to come out of that at all. I > think that is why we are now going to try doxazosin. I think almost > everything has been tried and at best there is no effect and at worst > I end up in ICU. Maybe the high uncontrolled BP is something I just > have to accept. I know I am just about out of options. > > > > Helen in Scotland > > > > > > Need to know what the normal values are for that lab renin and > aldo > > to make a better interpetation. > > > > If no PA this seems like a very high aldo but units of the assay > are > > key to know. > > > > Increases with slight weight gain suggests either weight sensitive > BP > > or Salt sensitive BP or both. > > > > Keep working on it. > > > > My approach would be to use difficult HTN approach outlines in my > > file. But you may have failed many of these. > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2008 Report Share Posted May 9, 2008 It was taken orally and within 10 minutes I was hot and itchy and came out in blisters like I had been burnt. My BP was taken immediately and every 15 minutes afterwards. Within 30 minutes I had become violent and had to be restrained..... I remember nothing after the blisters started. Guess it was an exteme allergic reaction. Helen in Scotland > > > > > > Need to know what the normal values are for that lab renin and > > aldo > > > to make a better interpetation. > > > > > > If no PA this seems like a very high aldo but units of the assay > > are > > > key to know. > > > > > > Increases with slight weight gain suggests either weight sensitive > > BP > > > or Salt sensitive BP or both. > > > > > > Keep working on it. > > > > > > My approach would be to use difficult HTN approach outlines in my > > > file. But you may have failed many of these. > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2008 Report Share Posted May 9, 2008 YOu had an anaphylactic reaction to the benazapirl the ACE in Lotrel- in all likelihood and should not be challanged again with an ACE and would do ARBS very carefully. Besides ACEs done work in PA as these is no AI to block. Wear this on your sleeve and keep in your purse and tell anyone who might take you to a hospital in an emergency. On May 9, 2008, at 2:36 PM, Helen wrote: > It was taken orally and within 10 minutes I was hot and itchy and > came out in blisters like I had been burnt. My BP was taken > immediately and every 15 minutes afterwards. Within 30 minutes I had > become violent and had to be restrained..... I remember nothing after > the blisters started. > > Guess it was an exteme allergic reaction. > > Helen in Scotland > > > > > > > > > > Need to know what the normal values are for that lab renin and > > > aldo > > > > to make a better interpetation. > > > > > > > > If no PA this seems like a very high aldo but units of the assay > > > are > > > > key to know. > > > > > > > > Increases with slight weight gain suggests either weight > sensitive > > > BP > > > > or Salt sensitive BP or both. > > > > > > > > Keep working on it. > > > > > > > > My approach would be to use difficult HTN approach outlines in > my > > > > file. But you may have failed many of these. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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