Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling

Motonori Nagasawa, Koichi Yamamoto, Hiromi Rakugi, Masao Takeda, Hiroshi Akasaka, Hironobu Umakoshi, Mika Tsuiki, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Takamasa Ichijo, Takuyuki Katabami, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi TakahashiMegumi Fujita, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Atsushi Ogo, Shintaro Okamura, Shozo Miyauchi, Toshihiko Yanase, Tomoko Suzuki, Takashi Kawamura, Mitsuhide Naruse

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

抄録

Objectives:Because of the influence on the renin-angiotensin-aldosterone system, it is recommended to avoid, if possible, the use of angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, diuretics, β-blockers, and mineralocorticoid receptor antagonists during the diagnostic period of primary aldosteronism. A laterality index more than 4 in adrenocorticotropic hormone (ACTH)-stimulated adrenal venous sampling (ACTH-AVS) is a widely used classification of the unilateral subtype that can benefit from adrenalectomy. Here, we revealed clinical features of patients taking drugs that could affect the primary aldosteronism diagnosis (DAPD) and investigated whether the classification with laterality index more than 4 in ACTH-AVS is applicable to these patients.Patients and methods:Using a large database of primary aldosteronism patients in Japan, we analyzed 2122 patients with successful ACTH-AVS.Results:Patients who received any DAPD (n = 209) showed higher prevalence of comorbidity burdens and took more antihypertensive drugs compared with patients without DAPD. In patients taking DAPD, those with laterality index more than 4 had a higher prevalence of hypokalemia, a higher aldosterone-to-renin ratio and a higher prevalence of adrenal mass than those with laterality index of 4 or less. Adrenalectomy was performed in 76% patients with laterality index more than 4 and 20% with laterality index of 4 or less. Patients who underwent adrenalectomy showed biochemical cure in 89% with laterality index more than 4 and 50% with laterality index of 4 or less (P = 0.001). Multivariate regression analysis showed that laterality index more than 4 was an independent predictor of a biochemical cure. Biochemical cure rate in patients with laterality index more than 4 was consistently high, irrespective of the potential effect of individual DAPD on laterality index.Conclusion:Our findings suggest that in primary aldosteronism patients to whom DAPD were administrated due to severe clinical features, laterality index more than 4 in ACTH-AVS could accurately predict a biochemical cure after adrenalectomy.

元の言語英語
ページ(範囲)1493-1499
ページ数7
ジャーナルJournal of hypertension
37
発行部数7
DOI
出版物ステータス出版済み - 7 1 2019

Fingerprint

Hyperaldosteronism
Antihypertensive Agents
Adrenalectomy
Adrenocorticotropic Hormone
Mineralocorticoid Receptor Antagonists
Angiotensin II Type 1 Receptor Blockers
Hypokalemia
Renin-Angiotensin System
Aldosterone
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Renin
Comorbidity
Japan
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

これを引用

Nagasawa, M., Yamamoto, K., Rakugi, H., Takeda, M., Akasaka, H., Umakoshi, H., ... Naruse, M. (2019). Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling. Journal of hypertension, 37(7), 1493-1499. https://doi.org/10.1097/HJH.0000000000002047

Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling. / Nagasawa, Motonori; Yamamoto, Koichi; Rakugi, Hiromi; Takeda, Masao; Akasaka, Hiroshi; Umakoshi, Hironobu; Tsuiki, Mika; Takeda, Yoshiyu; Kurihara, Isao; Itoh, Hiroshi; Ichijo, Takamasa; Katabami, Takuyuki; Wada, Norio; Shibayama, Yui; Yoshimoto, Takanobu; Ogawa, Yoshihiro; Kawashima, Junji; Sone, Masakatsu; Inagaki, Nobuya; Takahashi, Katsutoshi; Fujita, Megumi; Watanabe, Minemori; Matsuda, Yuichi; Kobayashi, Hiroki; Shibata, Hirotaka; Kamemura, Kohei; Otsuki, Michio; Fujii, Yuichi; Ogo, Atsushi; Okamura, Shintaro; Miyauchi, Shozo; Yanase, Toshihiko; Suzuki, Tomoko; Kawamura, Takashi; Naruse, Mitsuhide.

:: Journal of hypertension, 巻 37, 番号 7, 01.07.2019, p. 1493-1499.

研究成果: ジャーナルへの寄稿記事

Nagasawa, M, Yamamoto, K, Rakugi, H, Takeda, M, Akasaka, H, Umakoshi, H, Tsuiki, M, Takeda, Y, Kurihara, I, Itoh, H, Ichijo, T, Katabami, T, Wada, N, Shibayama, Y, Yoshimoto, T, Ogawa, Y, Kawashima, J, Sone, M, Inagaki, N, Takahashi, K, Fujita, M, Watanabe, M, Matsuda, Y, Kobayashi, H, Shibata, H, Kamemura, K, Otsuki, M, Fujii, Y, Ogo, A, Okamura, S, Miyauchi, S, Yanase, T, Suzuki, T, Kawamura, T & Naruse, M 2019, 'Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling', Journal of hypertension, 巻. 37, 番号 7, pp. 1493-1499. https://doi.org/10.1097/HJH.0000000000002047
Nagasawa, Motonori ; Yamamoto, Koichi ; Rakugi, Hiromi ; Takeda, Masao ; Akasaka, Hiroshi ; Umakoshi, Hironobu ; Tsuiki, Mika ; Takeda, Yoshiyu ; Kurihara, Isao ; Itoh, Hiroshi ; Ichijo, Takamasa ; Katabami, Takuyuki ; Wada, Norio ; Shibayama, Yui ; Yoshimoto, Takanobu ; Ogawa, Yoshihiro ; Kawashima, Junji ; Sone, Masakatsu ; Inagaki, Nobuya ; Takahashi, Katsutoshi ; Fujita, Megumi ; Watanabe, Minemori ; Matsuda, Yuichi ; Kobayashi, Hiroki ; Shibata, Hirotaka ; Kamemura, Kohei ; Otsuki, Michio ; Fujii, Yuichi ; Ogo, Atsushi ; Okamura, Shintaro ; Miyauchi, Shozo ; Yanase, Toshihiko ; Suzuki, Tomoko ; Kawamura, Takashi ; Naruse, Mitsuhide. / Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling. :: Journal of hypertension. 2019 ; 巻 37, 番号 7. pp. 1493-1499.
@article{16dabb80e24f44c59e00ef5ea7abf3ef,
title = "Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling",
abstract = "Objectives:Because of the influence on the renin-angiotensin-aldosterone system, it is recommended to avoid, if possible, the use of angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, diuretics, β-blockers, and mineralocorticoid receptor antagonists during the diagnostic period of primary aldosteronism. A laterality index more than 4 in adrenocorticotropic hormone (ACTH)-stimulated adrenal venous sampling (ACTH-AVS) is a widely used classification of the unilateral subtype that can benefit from adrenalectomy. Here, we revealed clinical features of patients taking drugs that could affect the primary aldosteronism diagnosis (DAPD) and investigated whether the classification with laterality index more than 4 in ACTH-AVS is applicable to these patients.Patients and methods:Using a large database of primary aldosteronism patients in Japan, we analyzed 2122 patients with successful ACTH-AVS.Results:Patients who received any DAPD (n = 209) showed higher prevalence of comorbidity burdens and took more antihypertensive drugs compared with patients without DAPD. In patients taking DAPD, those with laterality index more than 4 had a higher prevalence of hypokalemia, a higher aldosterone-to-renin ratio and a higher prevalence of adrenal mass than those with laterality index of 4 or less. Adrenalectomy was performed in 76{\%} patients with laterality index more than 4 and 20{\%} with laterality index of 4 or less. Patients who underwent adrenalectomy showed biochemical cure in 89{\%} with laterality index more than 4 and 50{\%} with laterality index of 4 or less (P = 0.001). Multivariate regression analysis showed that laterality index more than 4 was an independent predictor of a biochemical cure. Biochemical cure rate in patients with laterality index more than 4 was consistently high, irrespective of the potential effect of individual DAPD on laterality index.Conclusion:Our findings suggest that in primary aldosteronism patients to whom DAPD were administrated due to severe clinical features, laterality index more than 4 in ACTH-AVS could accurately predict a biochemical cure after adrenalectomy.",
author = "Motonori Nagasawa and Koichi Yamamoto and Hiromi Rakugi and Masao Takeda and Hiroshi Akasaka and Hironobu Umakoshi and Mika Tsuiki and Yoshiyu Takeda and Isao Kurihara and Hiroshi Itoh and Takamasa Ichijo and Takuyuki Katabami and Norio Wada and Yui Shibayama and Takanobu Yoshimoto and Yoshihiro Ogawa and Junji Kawashima and Masakatsu Sone and Nobuya Inagaki and Katsutoshi Takahashi and Megumi Fujita and Minemori Watanabe and Yuichi Matsuda and Hiroki Kobayashi and Hirotaka Shibata and Kohei Kamemura and Michio Otsuki and Yuichi Fujii and Atsushi Ogo and Shintaro Okamura and Shozo Miyauchi and Toshihiko Yanase and Tomoko Suzuki and Takashi Kawamura and Mitsuhide Naruse",
year = "2019",
month = "7",
day = "1",
doi = "10.1097/HJH.0000000000002047",
language = "English",
volume = "37",
pages = "1493--1499",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling

AU - Nagasawa, Motonori

AU - Yamamoto, Koichi

AU - Rakugi, Hiromi

AU - Takeda, Masao

AU - Akasaka, Hiroshi

AU - Umakoshi, Hironobu

AU - Tsuiki, Mika

AU - Takeda, Yoshiyu

AU - Kurihara, Isao

AU - Itoh, Hiroshi

AU - Ichijo, Takamasa

AU - Katabami, Takuyuki

AU - Wada, Norio

AU - Shibayama, Yui

AU - Yoshimoto, Takanobu

AU - Ogawa, Yoshihiro

AU - Kawashima, Junji

AU - Sone, Masakatsu

AU - Inagaki, Nobuya

AU - Takahashi, Katsutoshi

AU - Fujita, Megumi

AU - Watanabe, Minemori

AU - Matsuda, Yuichi

AU - Kobayashi, Hiroki

AU - Shibata, Hirotaka

AU - Kamemura, Kohei

AU - Otsuki, Michio

AU - Fujii, Yuichi

AU - Ogo, Atsushi

AU - Okamura, Shintaro

AU - Miyauchi, Shozo

AU - Yanase, Toshihiko

AU - Suzuki, Tomoko

AU - Kawamura, Takashi

AU - Naruse, Mitsuhide

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objectives:Because of the influence on the renin-angiotensin-aldosterone system, it is recommended to avoid, if possible, the use of angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, diuretics, β-blockers, and mineralocorticoid receptor antagonists during the diagnostic period of primary aldosteronism. A laterality index more than 4 in adrenocorticotropic hormone (ACTH)-stimulated adrenal venous sampling (ACTH-AVS) is a widely used classification of the unilateral subtype that can benefit from adrenalectomy. Here, we revealed clinical features of patients taking drugs that could affect the primary aldosteronism diagnosis (DAPD) and investigated whether the classification with laterality index more than 4 in ACTH-AVS is applicable to these patients.Patients and methods:Using a large database of primary aldosteronism patients in Japan, we analyzed 2122 patients with successful ACTH-AVS.Results:Patients who received any DAPD (n = 209) showed higher prevalence of comorbidity burdens and took more antihypertensive drugs compared with patients without DAPD. In patients taking DAPD, those with laterality index more than 4 had a higher prevalence of hypokalemia, a higher aldosterone-to-renin ratio and a higher prevalence of adrenal mass than those with laterality index of 4 or less. Adrenalectomy was performed in 76% patients with laterality index more than 4 and 20% with laterality index of 4 or less. Patients who underwent adrenalectomy showed biochemical cure in 89% with laterality index more than 4 and 50% with laterality index of 4 or less (P = 0.001). Multivariate regression analysis showed that laterality index more than 4 was an independent predictor of a biochemical cure. Biochemical cure rate in patients with laterality index more than 4 was consistently high, irrespective of the potential effect of individual DAPD on laterality index.Conclusion:Our findings suggest that in primary aldosteronism patients to whom DAPD were administrated due to severe clinical features, laterality index more than 4 in ACTH-AVS could accurately predict a biochemical cure after adrenalectomy.

AB - Objectives:Because of the influence on the renin-angiotensin-aldosterone system, it is recommended to avoid, if possible, the use of angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, diuretics, β-blockers, and mineralocorticoid receptor antagonists during the diagnostic period of primary aldosteronism. A laterality index more than 4 in adrenocorticotropic hormone (ACTH)-stimulated adrenal venous sampling (ACTH-AVS) is a widely used classification of the unilateral subtype that can benefit from adrenalectomy. Here, we revealed clinical features of patients taking drugs that could affect the primary aldosteronism diagnosis (DAPD) and investigated whether the classification with laterality index more than 4 in ACTH-AVS is applicable to these patients.Patients and methods:Using a large database of primary aldosteronism patients in Japan, we analyzed 2122 patients with successful ACTH-AVS.Results:Patients who received any DAPD (n = 209) showed higher prevalence of comorbidity burdens and took more antihypertensive drugs compared with patients without DAPD. In patients taking DAPD, those with laterality index more than 4 had a higher prevalence of hypokalemia, a higher aldosterone-to-renin ratio and a higher prevalence of adrenal mass than those with laterality index of 4 or less. Adrenalectomy was performed in 76% patients with laterality index more than 4 and 20% with laterality index of 4 or less. Patients who underwent adrenalectomy showed biochemical cure in 89% with laterality index more than 4 and 50% with laterality index of 4 or less (P = 0.001). Multivariate regression analysis showed that laterality index more than 4 was an independent predictor of a biochemical cure. Biochemical cure rate in patients with laterality index more than 4 was consistently high, irrespective of the potential effect of individual DAPD on laterality index.Conclusion:Our findings suggest that in primary aldosteronism patients to whom DAPD were administrated due to severe clinical features, laterality index more than 4 in ACTH-AVS could accurately predict a biochemical cure after adrenalectomy.

UR - http://www.scopus.com/inward/record.url?scp=85067266283&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067266283&partnerID=8YFLogxK

U2 - 10.1097/HJH.0000000000002047

DO - 10.1097/HJH.0000000000002047

M3 - Article

C2 - 31033727

AN - SCOPUS:85067266283

VL - 37

SP - 1493

EP - 1499

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 7

ER -