ALDOSTERONE ELEVATION DURING LUTEAL PHASE OF THE MENSTRUAL CYCLE MAY SUGGEST PRIMARY ALDOSTERONISM IN HYPERTENSIVE WOMEN Objective. Primary aldosteronism is a low-renin hypertensive condition which has being increasingly diagnosed in the last years. It is known that plasma aldosterone (ALDO) concentration may increase during the luteal phase of the menstrual cycle in normal women, particularly in the premenstrual syndrome. We here report some observations on the spontaneous changes of plasma ALDO during the menstrual cycle in hypertensive women. Design and Method. Eleven reproductive-age essential hypertensive women (mean age 41, range 33-53 yrs) with known low renin values ( PRA<1 ng/ml/hr) under no antihypertensive treatment were studied four times during one menstrual cycle (at days 7, 14, 21, 28). Plasma samples were taken at 08:30 hr in the morning and assayed for LDH, FSH, 17 beta-estradiol, progesterone, aldosterone (ALDO) and PRA. Results. The hormonal profile of each menstrual cycle was normal except for one patient who showed a non-ovulatory pattern. At day 7 normal ALDO and low PRA values were observed except for one patient with 1.2 ng/ml/hr PRA. During the luteal phase a significant increase in ALDO levels was observed (p<0.005, ANOVA test) with a resultant increase in ALDO/PRA ratio, as showed in the table. In particular, five patients showed ALDO levels above the normal range in the presence of low PRA values. A direct correlation was observed between ALDO and progesterone levels (p<0.02). Table: PRA, ALDO and ALDO/PRA ratio (mean values and ranges). Day 7 Day 14 Day 21 Day 28 PRA (ng/ml/hr) 0.34 (0.2-1.2) 0.68 (0.2-3.3) 0.59 (0.2-1.8) 0.46 (0.2-1.5) ALDO (ng/dl) 8.8 (6.1-14.6) 13.1 (7.5-22.7) 17.9 (5.5-33.6) 16.4 (7.3-28.9) ALDO/PRA 36 (5-63) 36 (2-66) 41 (7-92) 45 (16-70) Conclusions. Our observations confirm that ALDO levels may change during the menstrual cycle; abnormally high ALDO and low PRA values may be observed during the luteal phase. These facts should be taken into account when screening for primary aldosteronism in hypertensive women of reproductive age.
Aldosterone elevation during the luteal phase of the menstrual cycle may suggest primary aldosteronism in hypertensive women
FOMMEI, ENZA;
2005-01-01
Abstract
ALDOSTERONE ELEVATION DURING LUTEAL PHASE OF THE MENSTRUAL CYCLE MAY SUGGEST PRIMARY ALDOSTERONISM IN HYPERTENSIVE WOMEN Objective. Primary aldosteronism is a low-renin hypertensive condition which has being increasingly diagnosed in the last years. It is known that plasma aldosterone (ALDO) concentration may increase during the luteal phase of the menstrual cycle in normal women, particularly in the premenstrual syndrome. We here report some observations on the spontaneous changes of plasma ALDO during the menstrual cycle in hypertensive women. Design and Method. Eleven reproductive-age essential hypertensive women (mean age 41, range 33-53 yrs) with known low renin values ( PRA<1 ng/ml/hr) under no antihypertensive treatment were studied four times during one menstrual cycle (at days 7, 14, 21, 28). Plasma samples were taken at 08:30 hr in the morning and assayed for LDH, FSH, 17 beta-estradiol, progesterone, aldosterone (ALDO) and PRA. Results. The hormonal profile of each menstrual cycle was normal except for one patient who showed a non-ovulatory pattern. At day 7 normal ALDO and low PRA values were observed except for one patient with 1.2 ng/ml/hr PRA. During the luteal phase a significant increase in ALDO levels was observed (p<0.005, ANOVA test) with a resultant increase in ALDO/PRA ratio, as showed in the table. In particular, five patients showed ALDO levels above the normal range in the presence of low PRA values. A direct correlation was observed between ALDO and progesterone levels (p<0.02). Table: PRA, ALDO and ALDO/PRA ratio (mean values and ranges). Day 7 Day 14 Day 21 Day 28 PRA (ng/ml/hr) 0.34 (0.2-1.2) 0.68 (0.2-3.3) 0.59 (0.2-1.8) 0.46 (0.2-1.5) ALDO (ng/dl) 8.8 (6.1-14.6) 13.1 (7.5-22.7) 17.9 (5.5-33.6) 16.4 (7.3-28.9) ALDO/PRA 36 (5-63) 36 (2-66) 41 (7-92) 45 (16-70) Conclusions. Our observations confirm that ALDO levels may change during the menstrual cycle; abnormally high ALDO and low PRA values may be observed during the luteal phase. These facts should be taken into account when screening for primary aldosteronism in hypertensive women of reproductive age.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
