Acute Haemodynamic and Hormonal Effects of Oral Doxazosin in Normal Subjects

Whitworth, Judith A.; Butty, Jill; Gordon, D.

doi:10.1111/j.1440-1681.1987.tb00967.x

Cited by 12 publications

(7 citation statements)

References 4 publications

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“…The effect of doxazosin on the ARR is very small, as also observed after acute and chronic usage. 20,21 In contrast, the effect of fosinopril on ARR is more evident but does not result in any false diagnosis of essential hypertension in patients with PA. This is in agreement with the proposal that ACE-Is can be used to confirm the diagnosis of PA. 30,31 Previous studies have shown that ACE-Is, such as enalapril, are effective in reducing blood pressure and aldosterone secretion in patients with PA. 32 This could be owing to the inhibition of angiotensin II generation, to which IHA patients display enhanced sensitivity.…”

Section: Discussionmentioning

confidence: 97%

Drug Effects on Aldosterone/Plasma Renin Activity Ratio in Primary Aldosteronism

et al. 2002

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Abstract-Primary aldosteronism is a specifically treatable and potentially curable form of secondary hypertension. The aldosterone/plasma renin activity ratio (ARR) is routinely used as a screening test. Antihypertensive therapy can interfere with the interpretation of this parameter, but a correct washout period can be potentially harmful. We have investigated the effects of therapy with atenolol, amlodipine, doxazosin, fosinopril, and irbesartan on the ARR in a group of 230 patients with suspected primary aldosteronism. The percent change from control of ARR in patients taking amlodipine was Ϫ17%Ϯ32; atenolol, 62%Ϯ82; doxazosin, Ϫ5%Ϯ26; fosinopril, Ϫ30%Ϯ24; and irbesartan, Ϫ43%Ϯ27. The ARR change induced by atenolol was significantly higher compared with that induced by all other drugs (PϽ0.0001), and the ARR change induced by irbesartan was significantly lower than that induced by doxazosin (PϽ0.0001). One of 55 patients from the group taking amlodipine (1.8%) and 4/17 of the patients taking irbesartan (23.5%) gave a false-negative ARR (Ͻ50). None of the patients of the groups taking fosinopril, doxazosin, and atenolol displayed a false-negative ARR. Doxazosin and fosinopril can be used in hypertensive patients who need to undergo aldosterone and PRA measurement for the diagnosis of primary aldosteronism; amlodipine gave a very small percentage of false-negative diagnoses. ␤-Blockers also do not interfere with the diagnosis of primary aldosteronism, but they can be responsible for an increased rate of false-positive ARRs. The high rate of false-negative diagnoses in patients undergoing irbesartan treatment requires confirmation in a higher number of patients.

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Section: Discussionmentioning

confidence: 97%

Drug Effects on Aldosterone/Plasma Renin Activity Ratio in Primary Aldosteronism

et al. 2002

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“…Similarly, numerous studies in humans have shown that the α 1 antagonists terazosin (Beretta-Piccoli et al, 1986), prazosin (Falch et al, 1979), and doxazosin (Oliveros-Palacios et al, 1991) reduce BP without any effect on peripheral aldosterone levels. Finally, research has shown that doxazosin administration does not result in sustained changes in either cortisol or aldosterone levels (Whitworth et al, 1987). In addition, the lack of changes in serum cortisol baseline levels may also reflect, at least in part, the absence of clinically-significant alcohol withdrawal during the study (Costa et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Higher pretreatment blood pressure is associated with greater alcohol drinking reduction in alcohol-dependent individuals treated with doxazosin

Haass‐Koffler

Goodyear

Zywiak

et al. 2017

Drug and Alcohol Dependence

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Background Preclinical and clinical research suggest that the α1 receptor antagonist prazosin reduces alcohol consumption. Furthermore, clinical studies indicate a role of prazosin in treating Post-Traumatic Stress Disorder (PTSD) symptoms, while a recent trial suggested that pre-treatment blood pressure (BP) predicts therapeutic response for prazosin in PTSD patients. Whether pre-treatment BP may predict response to α1 blockers in alcohol-dependent (AD) patients is unknown. We previously reported a randomized controlled trial (RCT), where doxazosin, an α1 receptor antagonist with a more favorable pharmacokinetic profile than prazosin, reduced drinks per week (DPW) and heavy drinking days (HDD) in AD patients with a high family history density of alcoholism. In this study, we tested pre-treatment BP as another potentially valuable clinical moderator of doxazosin’s response on alcohol consumption. Methods This was a double-blind placebo-controlled RCT testing doxazosin up to 16 mg/day in AD treatment-seeking patients (N = 41). The hypothesized moderator effect of baseline standing systolic and diastolic BP on DPW and HDD was tested. Results With pre-treatment standing diastolic BP as a moderator, there were significant BP × medication interactions for both DPW [**p= 0.009, d = 0.80] and HDD [*p = 0.018, d = 1.11]. Post-hoc analyses indicated significant doxazosin effects in patients with higher standing BP in reducing both DPW and HDD. Conclusion These findings suggest that higher standing diastolic BP at baseline (pre-treatment) may represent a predictor of doxazosin’s response on alcohol consumption in AD patients. These results further elucidate the possible efficacy and mechanisms of action of α1 receptor antagonism in AD individuals.

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“…71 Alpha-blockers such as doxazosin are associated with minimal decreases in aldosterone and ARR. [71][72][73] Thiazide diuretics can also cause a reduction in the ARR. 74,75…”

Section: Limitations/strengths Of This Studymentioning

confidence: 99%

Associations between glycaemic control and activation of the renin-angiotensin-aldosterone system in participants with type 2 diabetes mellitus and hypertension

et al. 2017

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Introduction Hyperglycaemia increases succinate concentrations and succinate receptor activation in the kidney resulting in renin release. The aim of our study was to determine if there is an association between glycaemic control as evidenced by glycated haemoglobin values and activation of the renin-angiotensin-aldosterone system in patients with type 2 diabetes mellitus and hypertension. Methods A cross-sectional study was conducted at Galway University Hospitals between December 2014 and March 2015. Participants ( n = 66) were identified following interrogation of the electronic database for patients with type 2 diabetes mellitus. Baseline clinical demographics, aldosterone, plasma renin activity, direct renin concentration, urea and electrolytes, glycated haemoglobin, cholesterol, urine sodium and albumin creatinine ratio were recorded. Results There was a significant positive linear correlation between glycated haemoglobin and renin (both plasma renin activity [ P = 0.002] and direct renin concentration [ P = 0.008]) and between serum creatinine and aldosterone measured using both radioimmunoassay ( P = 0.008) and immunochemiluminometric assay ( P = 0.008). A significant negative linear correlation was demonstrated between serum sodium and plasma renin activity ( P = 0.005) and direct renin concentration ( P = 0.015) and between estimated glomerular filtration rate and aldosterone measured using radioimmunoassay ( P = 0.02) and immunochemiluminometric assay ( P = 0.016). A significant negative linear correlation existed between urine sodium and plasma renin activity ( P = 0.04) and aldosterone measured using radioimmunoassay ( P = 0.045). Conclusions There is a direct positive association between glycaemic control and renin. We advocate for renin measurement to be part of the diabetologist's armamentarium to assess, guide and optimize therapeutic strategies in patients with diabetes.

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Acute Haemodynamic and Hormonal Effects of Oral Doxazosin in Normal Subjects

Cited by 12 publications

References 4 publications

Drug Effects on Aldosterone/Plasma Renin Activity Ratio in Primary Aldosteronism

Drug Effects on Aldosterone/Plasma Renin Activity Ratio in Primary Aldosteronism

Higher pretreatment blood pressure is associated with greater alcohol drinking reduction in alcohol-dependent individuals treated with doxazosin

Associations between glycaemic control and activation of the renin-angiotensin-aldosterone system in participants with type 2 diabetes mellitus and hypertension

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