Re: Re: Meds and Aldo Renin Levels

[Guest guest]

Thanks ms. I did forget to mention that is stopping meds in about 600 pts with difficult HTN we had no complications and indeed the BP was often no worse or even better.There is a publication in our files that has shown that many "usual BP meds" are used in low renin patients the BP actually goes up. Two authors are Alderman and Laragh.So I still recommend stopping meds, and measuring BP till meds have washed out. Rarely will I resume meds unless the pt becomes symptomatic with headache, SOB or chest pain.CE Grim MD On Jan 22, 2012, at 8:25 PM, msmith_1928 wrote: Norvasc is a calcium channel blocker. When I first started getting tested for PA, I was on Cardizem (also a calcium channel blocker) and Diovan (an ARB). At my first appointment with the nephrologist who eventually diagnosed me, the bloodwork that was done to test the aldosterone-renin ratio came back as normal - a false negative. He had me stop both the Cardizem and Diovan and re-test 2 weeks later. This was when I tested positive for PA. Interesting side note: immediately after stopping the Diovan and Cardizem, my BP dropped from 160s/100s to 140s/90s. In other words, the anti-hypertensives actually INCREASED my BP. So, I can't say with any certainty which of the two meds caused the false negative. My doctor's recommendation was to do all testing while not on any meds at all, which is what I ended up doing for the better part of last year. Hope that helps! -msmith1928 successful laparoscopic left adrenalectomy 10/13/2011 > > I read the files on meds that raise/lower levels. And meds that don't mess with the levels for eval of PA. It classifies them as Alpha, Beta, or Calcium Channel Blockers, etc. Can any of you give me a list of brand or generic names of these meds? I am out of my league and don't know if Norvasc is one of these, or any of my other meds are either. Thanks! >

[Guest guest]

Well if you look at the first VA trial (286 men only) participants had to have a DIASTOLIC pressure between 115-120 mm Hg after 6 days in the hospital on placebo and then 115-130 for 2-4 months as an outpatient on placebo. No complications during that time as I recall. Average BP at entry to the study after this was 186/121. After 4 months diastolic was 92 in active Rx group and 118 in the placebo group.However over the next 18 months those on 38% of those on placebo had events while those only 3% of those on Rx had events. Study had been designed to go for 5 years but was stopped at 18 months due to the dramatic difference. CE Grim MD On Jan 22, 2012, at 10:15 PM, msmith_1928 wrote:.. No complications in 600 pts off meds? That's something worth mentioning The abstract of the Alderman/Laragh article is on Pubmed but there are no free full-text sources that I can find: http://www.ncbi.nlm.nih.gov/pubmed/20725055 The conclusion was that low-renin pts had an elevated BP response to beta-blockers or ACEIs frequently enough to be of concern. I'd suggest adding CCBs and/or ARBs to that list of meds, as I was on neither BB or ACEI. > > > > > > I read the files on meds that raise/lower levels. And meds that > > don't mess with the levels for eval of PA. It classifies them as > > Alpha, Beta, or Calcium Channel Blockers, etc. Can any of you give > > me a list of brand or generic names of these meds? I am out of my > > league and don't know if Norvasc is one of these, or any of my other > > meds are either. Thanks! > > > > > > > >