{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:40:32Z","timestamp":1791520832602,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T00:00:00Z","timestamp":1442880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2016,3]]},"abstract":"Summary<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate the effects of \u03b2\u2010adrenoreceptor antagonists (\u03b2\u2010blockers) on the aldosterone\u2013renin ratio (ARR) in the context of antihypertensive polypharmacy in chronic hypertension. To determine the optimal duration of \u03b2\u2010blocker withdrawal required to normalize the ARR.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A prospective, longitudinal study design was employed investigating two groups whom either remained on or withdrew from \u03b2\u2010blocker therapy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Hypertensive individuals taking \u03b2\u2010blockers and a combination of thiazide diuretics, \u03b11\u2010blockers, calcium channel antagonists and angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blocker were recruited and followed over 10\u201312 weeks. \u03b2\u2010Blockers were withdrawn at the first visit. Blood pressure (BP) was measured at each visit and blood drawn serially for measurement of plasma renin activity (PRA), direct renin concentration (DRC) and aldosterone.\n BP<\/jats:styled-content>\n was optimized by maximizing non\u2010renin\u2010suppressing antihypertensives. Main outcomes were\n ARR<\/jats:styled-content>\n ,\n DRC<\/jats:styled-content>\n ,\n PRA<\/jats:styled-content>\n and aldosterone. Plasma renin activity was calculated from angiotensin I measured using radioimmunoassay (RIA), DRC was measured using chemiluminescent immunoassay assay, and aldosterone was measured using both\n RIA<\/jats:styled-content>\n and Chemilluminescence Assay (CIL).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n False\u2010positive\n ARR<\/jats:styled-content>\n for primary aldosteronism (\n PA<\/jats:styled-content>\n ) occurred in 31% of patients taking \u03b2\u2010blockers.\n ARR<\/jats:styled-content>\n returned to normal following \u03b2\u2010blocker withdrawal resulting from an increase in the\n DRC<\/jats:styled-content>\n and\n PRA<\/jats:styled-content>\n without affecting aldosterone. The optimum time for \u03b2\u2010blocker withdrawal was 2 weeks when using\n DRC<\/jats:styled-content>\n and 3 weeks for\n PRA<\/jats:styled-content>\n . \u03b2\u2010Blocker withdrawal did not adversely affect blood pressure.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Raised\n ARR<\/jats:styled-content>\n consequent to \u03b2\u2010blocker therapy causes false\u2010positive screening for\n PA<\/jats:styled-content>\n . Where \u03b2\u2010blockers can be safely withdrawn, this effect is reversed within 2\u20133 weeks depending on whether\n DRC<\/jats:styled-content>\n or\n PRA<\/jats:styled-content>\n is used to calculate\n ARR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cen.12882","type":"journal-article","created":{"date-parts":[[2015,8,24]],"date-time":"2015-08-24T06:52:17Z","timestamp":1440399137000},"page":"325-331","source":"Crossref","is-referenced-by-count":26,"title":["\u03b2\u2010Blocker withdrawal is preferable for accurate interpretation of the aldosterone\u2013renin ratio in chronically treated hypertension"],"prefix":"10.1111","volume":"84","author":[{"given":"Gerard A.","family":"Browne","sequence":"first","affiliation":[{"name":"Discipline of Pharmacology & Therapeutics Lambe Institute for Translational Research School of Medicine National University of Ireland Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s P.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology & Therapeutics Lambe Institute for Translational Research School of Medicine National University of Ireland Galway Ireland"},{"name":"Department of Endocrinology, Metabolism and Diabetes Mellitus Galway University Hospital Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula M.","family":"O'Shea","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Galway University Hospital Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Conall","family":"Dennedy","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology & Therapeutics Lambe Institute for Translational Research School of Medicine National University of Ireland Galway Ireland"},{"name":"Department of Endocrinology, Metabolism and Diabetes Mellitus Galway University Hospital Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.059"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1295438"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2006.07.003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.112.197111"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0444"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12645"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0681"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2116"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1295460"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02775.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0104"},{"key":"e_1_2_6_13_1","article-title":"The management of primary aldosteronism: case detection, diagnosis and treatment: an endocrine society practice guideline","author":"Funder J.W.","year":"2015","journal-title":"Journal of Clinical Endocrinology & Metabolism"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0225"},{"key":"e_1_2_6_15_1","article-title":"Establishment of reference intervals for aldosterone and renin in a Caucasian population using the newly developed IDS\u2010iSYS automated assay system","author":"O'Shea P.","year":"2015","journal-title":"Annals of Clinical Biochemistry"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2015.01.003"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1677\/joe.0.1320133"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-11-1013"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn377"}],"container-title":["Clinical 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