{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:17:23Z","timestamp":1772579843145,"version":"3.50.1"},"reference-count":35,"publisher":"The Endocrine Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Plasma aldosterone\/renin ratio (ARR) is the most popular screening test for primary aldosteronism (PA). Because both estrogen and progesterone (including in oral contraceptive agents) affect aldosterone and renin levels, we studied the effects of combined hormonal replacement therapy (HRT) on ARR; renin was measured as both direct renin concentration (DRC) and plasma renin activity (PRA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Fifteen normotensive, healthy postmenopausal women underwent measurement (seated, midmorning) of plasma aldosterone, DRC, PRA, electrolytes, and creatinine and urinary aldosterone, cortisol, electrolytes, and creatinine at baseline and after 2 weeks and 6 weeks of treatment with combined HRT (conjugated estrogens 0.625 mg and medroxyprogesterone 2.5 mg daily).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Combined HRT was associated with statistically significant increases in aldosterone [median (range): baseline, 150 (85 to 600); 2 weeks, 230 (129 to 790); 6 weeks, 434 (200 to 1200) pmol\/L; P &amp;lt; 0.001 (Friedman test)] and PRA [2.3 (1.2 to 4.3), 3.8 (1.4 to 7.0), 5.1 (1.4 to 10.8) ng\/mL\/h, respectively; P &amp;lt; 0.001] but decreases in DRC [21 (10 to 31), 21 (10 to 39), and 14 (8.0 to 30) mU\/L, respectively; P &amp;lt; 0.01], leading to increases in ARR calculated by DRC [7.8 (3.6 to 34.8), 11.4 (5.4 to 48.5), and 30.4 (10.5 to 90.2), respectively; P &amp;lt; 0.001]. The ARR calculated by DRC exceeded the cutoff value (70) in three patients after 6 weeks. There were no significant changes in ARR calculated by PRA [79 (26 to 184), 91 (23 to 166), and 88 (50 to 230), respectively; P = 0.282], plasma electrolytes and creatinine, or any urinary measurements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>The combined oral HRT used in this study is capable of significantly increasing ARR with a risk of false-positive results during screening for PA but only if DRC (and not PRA) is used to calculate the ratio.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2016-3851","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T07:57:19Z","timestamp":1490947039000},"page":"2329-2334","source":"Crossref","is-referenced-by-count":26,"title":["Effect of Combined Hormonal Replacement Therapy on the Aldosterone\/Renin Ratio in Postmenopausal Women"],"prefix":"10.1210","volume":"102","author":[{"given":"Ashraf H.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane 4102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard D.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane 4102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Ward","sequence":"additional","affiliation":[{"name":"Sullivan & Nicolaides Pathology, Brisbane 4068, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Wolley","sequence":"additional","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane 4102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett C.","family":"McWhinney","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobus P.","family":"Ungerer","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Stowasser","sequence":"additional","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane 4102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2017,3,30]]},"reference":[{"issue":"4","key":"2020071623114619200_B1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S1521-690X(03)00050-2","article-title":"Primary aldosteronism","volume":"17","author":"Stowasser","year":"2003","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"2","key":"2020071623114619200_B2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1001\/archinte.1969.00300120040006","article-title":"Commentary on incidence of primary aldosteronism: current estimations based on objective data","volume":"123","author":"Kaplan","year":"1969","journal-title":"Arch Intern Med"},{"issue":"4","key":"2020071623114619200_B3","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1440-1681.1994.tb02519.x","article-title":"High incidence of primary aldosteronism in 199 patients referred with hypertension","volume":"21","author":"Gordon","year":"1994","journal-title":"Clin Exp Pharmacol Physiol"},{"issue":"5","key":"2020071623114619200_B4","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1038\/sj.jhh.1001013","article-title":"High prevalence of primary aldosteronism in the Tayside hypertension clinic population","volume":"14","author":"Lim","year":"2000","journal-title":"J Hum Hypertens"},{"issue":"8","key":"2020071623114619200_B5","first-page":"2854","article-title":"Prevalence of primary aldosteronism among Asian hypertensive patients in Singapore","volume":"85","author":"Loh","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2020071623114619200_B6","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1291\/hypres.30.103","article-title":"Is primary aldosteronism rare or common among hypertensive patients?","volume":"30","author":"Nishikawa","year":"2007","journal-title":"Hypertens Res"},{"issue":"11","key":"2020071623114619200_B7","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1016\/j.jacc.2006.07.059","article-title":"A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients","volume":"48","author":"Rossi","year":"2006","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"2020071623114619200_B8","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/00045415-199907000-00012","article-title":"Primary aldosteronism: a common and curable form of hypertension","volume":"7","author":"Young","year":"1999","journal-title":"Cardiol Rev"},{"issue":"7","key":"2020071623114619200_B9","doi-asserted-by":"crossref","first-page":"3201","DOI":"10.1210\/jc.2010-0225","article-title":"Effect of atenolol on aldosterone\/renin ratio calculated by both plasma Renin activity and direct Renin concentration in healthy male volunteers","volume":"95","author":"Ahmed","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2020071623114619200_B10","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1161\/01.HYP.0000038478.59760.41","article-title":"Drug effects on aldosterone\/plasma renin activity ratio in primary aldosteronism","volume":"40","author":"Mulatero","year":"2002","journal-title":"Hypertension"},{"issue":"4","key":"2020071623114619200_B11","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1046\/j.1365-2265.2002.01613.x","article-title":"Influence of antihypertensive medication on aldosterone and renin concentration in the differential diagnosis of essential hypertension and primary aldosteronism","volume":"57","author":"Seifarth","year":"2002","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2020071623114619200_B12","first-page":"457","article-title":"Effects of nifedipine treatment on the renin-angiotensin-aldosterone axis","volume":"82","author":"Fiad","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2020071623114619200_B13","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1038\/clpt.1980.221","article-title":"Effects of two nonsteroidal anti-inflammatory drugs, indomethacin and oxaprozin, on the kidney","volume":"28","author":"Mitnick","year":"1980","journal-title":"Clin Pharmacol Ther"},{"issue":"4","key":"2020071623114619200_B14","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1210\/jc.2010-2603","article-title":"Effects of two selective serotonin reuptake inhibitor antidepressants, sertraline and escitalopram, on aldosterone\/renin ratio in normotensive depressed male patients","volume":"96","author":"Ahmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2020071623114619200_B15","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3317\/jraas.2001.022","article-title":"Diagnosis and management of primary aldosteronism","volume":"2","author":"Stowasser","year":"2001","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"2020071623114619200_B16","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/01.ten.0000139006.29471.9e","article-title":"The aldosterone-renin ratio in screening for primary aldosteronism","volume":"14","author":"Stowasser","year":"2004","journal-title":"Endocrinologist"},{"issue":"5","key":"2020071623114619200_B17","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1210\/jcem-73-5-952","article-title":"Diagnosis under random conditions of all disorders of the renin-angiotensin-aldosterone axis, including primary hyperaldosteronism","volume":"73","author":"McKenna","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2020071623114619200_B18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/BF03349761","article-title":"Primary aldosteronism","volume":"18","author":"Gordon","year":"1995","journal-title":"J Endocrinol Invest"},{"issue":"10","key":"2020071623114619200_B19","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1172\/JCI105464","article-title":"A diurnal rhythm in plasma renin activity in man","volume":"45","author":"Gordon","year":"1966","journal-title":"J Clin Invest"},{"issue":"4","key":"2020071623114619200_B20","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/00004872-199204000-00007","article-title":"Regulation of angiotensinogen gene expression by estrogen","volume":"10","author":"Gordon","year":"1992","journal-title":"J Hypertens"},{"issue":"4","key":"2020071623114619200_B21","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/0039-128X(96)00007-4","article-title":"Effects of estrogens and progestogens on the renin-aldosterone system and blood pressure","volume":"61","author":"Oelkers","year":"1996","journal-title":"Steroids"},{"issue":"5","key":"2020071623114619200_B22","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1210\/jcem-39-5-882","article-title":"Effects of progesterone and four synthetic progestagens on sodium balance and the renin-aldosterone system in man","volume":"39","author":"Oelkers","year":"1974","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2020071623114619200_B23","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1210\/jcem-29-4-558","article-title":"Plasma renin activity and aldosterone excretion rate in normal subjects. II. Effect of oral contraceptive agents","volume":"29","author":"Crane","year":"1969","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2020071623114619200_B24","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1210\/jcem-39-6-1001","article-title":"Plasma renin activity, renin substrate and aldosterone during treatment with various oral contraceptives","volume":"39","author":"Katz","year":"1974","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2020071623114619200_B25","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1210\/jc.2010-2918","article-title":"Effect of contraceptives on aldosterone\/renin ratio may vary according to the components of contraceptive, renin assay method, and possibly route of administration","volume":"96","author":"Ahmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2020071623114619200_B26","doi-asserted-by":"crossref","first-page":"E340","DOI":"10.1210\/jc.2010-1355","article-title":"Are women more at risk of false-positive primary aldosteronism screening and unnecessary suppression testing than men?","volume":"96","author":"Ahmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2020071623114619200_B27","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00004872-200402000-00006","article-title":"The challenge of more robust and reproducible methodology in screening for primary aldosteronism","volume":"22","author":"Gordon","year":"2004","journal-title":"J Hypertens"},{"issue":"9","key":"2020071623114619200_B28","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1373\/clinchem.2006.068502","article-title":"Automated chemiluminescence-immunoassay for aldosterone during dynamic testing: comparison to radioimmunoassays with and without extraction steps","volume":"52","author":"Schirpenbach","year":"2006","journal-title":"Clin Chem"},{"issue":"6","key":"2020071623114619200_B29","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1373\/clinchem.2008.116004","article-title":"Measurement of aldosterone in human plasma by semiautomated HPLC-tandem mass spectrometry","volume":"55","author":"Taylor","year":"2009","journal-title":"Clin Chem"},{"issue":"1","key":"2020071623114619200_B30","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/cvr\/5.1.86","article-title":"Kinetics of the human renin and human substrate reaction","volume":"5","author":"Gould","year":"1971","journal-title":"Cardiovasc Res"},{"issue":"10-13","key":"2020071623114619200_B31","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.steroids.2003.08.008","article-title":"Conception and pharmacodynamic profile of drospirenone","volume":"68","author":"Elger","year":"2003","journal-title":"Steroids"},{"issue":"2-3","key":"2020071623114619200_B32","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/0009-8981(87)90183-5","article-title":"The effect of oral contraceptives on plasma-free and salivary cortisol and cortisone","volume":"165","author":"Meulenberg","year":"1987","journal-title":"Clin Chim Acta"},{"key":"2020071623114619200_B33","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1172\/JCI104931","article-title":"Transcortin: a corticosteroid-binding protein of plasma. VII. Half-life in normal and estrogen-treated subjects","volume":"43","author":"Sandberg","year":"1964","journal-title":"J Clin Invest"},{"issue":"12","key":"2020071623114619200_B34","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1016\/j.amjhyper.2007.08.009","article-title":"Laboratory diagnosis of primary aldosteronism, and drospirenone-ethinylestradiol therapy","volume":"20","author":"Pizzolo","year":"2007","journal-title":"Am J Hypertens"},{"issue":"1","key":"2020071623114619200_B35","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/HJH.0b013e32833266e3","article-title":"Effects of female sex hormones and contraceptive pill on the diagnostic work-up for primary aldosteronism","volume":"28","author":"Pizzolo","year":"2010","journal-title":"J Hypertens"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/102\/7\/2329\/18171363\/jc.2016-3851.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/102\/7\/2329\/18171363\/jc.2016-3851.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T11:58:14Z","timestamp":1594987094000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/102\/7\/2329\/3093639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,30]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2016-3851","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,7,1]]},"published":{"date-parts":[[2017,3,30]]}}}