Guest guest Posted September 19, 2010 Report Share Posted September 19, 2010 I do know they have there system thats runs on a MAC. I did find this web page with a demo of the system. But maybe only works in windows. CPRS Demo > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done after you ate a lot of salt > > > > > > > > > and was done early in menstrual cycle. You should read this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS > > > > > > > > > Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc. > > > > > > > > > 2006-1154 > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > Full Text (PDF) > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > Alert me when this article is cited > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > Alert me if a correction is posted > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > Similar articles in this journal > > > > > > > > > Similar articles in PubMed > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > Download to citation manager > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > Compound via MeSH > > > > > > > > > Substance via MeSH > > > > > > > > > Hazardous Substances DB > > > > > > > > > ESTRADIOL > > > > > > > > > PROGESTERONE > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > Female Endocrinology > > > > > > > > > The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 10 > > > > > > > > > 3981-3987 > > > > > > > > > Copyright © 2006 by The Endocrine Society > > > > > > > > > Relationship between Aldosterone and Progesterone in the Human > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, S. , Dina E. > > > > > > > > > Green, Tham M. Yao, N. Hopkins and Ellen W. Seely > > > > > > > > > Division of Endocrinology, Diabetes and Hypertension (E.D.S., > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), Department of Medicine, > > > > > > > > > Brigham and Women's Hospital, Harvard Medical School, Boston, > > > > > > > > > Massachusetts 02115; and Department of Medicine (P.N.H.), University > > > > > > > > > of Utah School of Medicine, Salt Lake City, Utah 84132 > > > > > > > > > > > > > > > > > > Address all correspondence and requests for reprints to: Ellen W. > > > > > > > > > Seely, M.D., Division of Endocrinology, Diabetes and Hypertension, > > > > > > > > > Brigham and Women's Hospital, 221 Longwood Avenue, Boston, > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > Top > > > > > > > > > Abstract > > > > > > > > > Introduction > > > > > > > > > Subjects and Methods > > > > > > > > > Results > > > > > > > > > Discussion > > > > > > > > > References > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase during the luteal phase of the > > > > > > > > > menstrual cycle. Prior studies examining relationships between > > > > > > > > > aldosterone and female sex hormones did not control for sodium > > > > > > > > > balance, a major determinant of aldosterone production. > > > > > > > > > Objectives: The objectives of this study were 1) to compare > > > > > > > > > aldosterone levels between menstrual phases among cycling women in > > > > > > > > > high- and low-sodium balance; and 2) to examine the relationships > > > > > > > > > between aldosterone and female sex hormones in women and the effects > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) cell aldosterone > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, premenopausal women were > > > > > > > > > studied in low- and/or high-sodium balance. Urinary aldosterone, > > > > > > > > > basal serum aldosterone, plasma renin activity (PRA), plasma > > > > > > > > > angiotensin II (AngII), and serum aldosterone after AngII infusion > > > > > > > > > were measured. Isolated rat ZG cells were treated with progesterone, > > > > > > > > > estradiol, or both, and aldosterone was measured. > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary aldosterone, basal serum > > > > > > > > > aldosterone, and serum aldosterone response to infused AngII were > > > > > > > > > significantly greater (P < 0.05) in the luteal vs. follicular phase. > > > > > > > > > PRA, AngII, and potassium did not differ. Progesterone directly > > > > > > > > > correlated with urinary aldosterone, basal serum aldosterone, and > > > > > > > > > serum aldosterone response to infused AngII. Estradiol did not > > > > > > > > > significantly correlate with aldosterone. In low-sodium balance, no > > > > > > > > > significant differences in aldosterone levels between phases were > > > > > > > > > found. In vitro, progesterone increased ZG cell aldosterone > > > > > > > > > production (P < 0.01), whereas estradiol had no effect. > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum aldosterone levels are > > > > > > > > > significantly higher during the luteal phase in high- but not low- > > > > > > > > > sodium balance, whereas PRA and AngII do not differ between phases. > > > > > > > > > Progesterone may directly contribute to increased luteal phase > > > > > > > > > aldosterone production, independent of the renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > Top > > > > > > > > > Abstract > > > > > > > > > Introduction > > > > > > > > > Subjects and Methods > > > > > > > > > Results > > > > > > > > > Discussion > > > > > > > > > References > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to increase during the luteal > > > > > > > > > phase of the human menstrual cycle, a time characterized by > > > > > > > > > increased progesterone and estradiol production. Although > > > > > > > > > progesterone is known to have antimineralocorticoid effects (1, 2, > > > > > > > > > 3), it is unclear whether additional mechanisms contribute to > > > > > > > > > increased luteal phase aldosterone production. Most prior studies > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, 11, 12) or document (13) > > > > > > > > > sodium balance, which plays a major role in regulation of > > > > > > > > > aldosterone production via the renin-angiotensin system (RAS). In > > > > > > > > > two prior studies that did account for sodium balance (14, 15), the > > > > > > > > > relationships between aldosterone and the female sex hormones > > > > > > > > > progesterone and estradiol were not investigated. > > > > > > > > > Progesterone is postulated to mediate the luteal phase increase in > > > > > > > > > aldosterone levels. Because progesterone inhibits aldosterone > > > > > > > > > binding to the mineralocorticoid receptor (1, 3, 16), increased > > > > > > > > > progesterone production during the luteal phase likely leads to > > > > > > > > > compensatory activation of the RAS and thus increased aldosterone > > > > > > > > > production (6, 8, 9, 12, 17). However, it is not known whether > > > > > > > > > additional mechanisms contribute to luteal phase aldosterone > > > > > > > > > increases, independent of the RAS. We examined the mechanisms by > > > > > > > > > which luteal phase aldosterone levels increase among women in sodium > > > > > > > > > balance, because differences in sodium balance independently > > > > > > > > > influence RAS hormone levels. Furthermore, we investigated the role > > > > > > > > > of estradiol in the luteal phase aldosterone increase, which has not > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > The purpose of this study was to compare aldosterone levels during > > > > > > > > > the follicular and luteal phases of the menstrual cycle among women > > > > > > > > > in documented sodium balance, at baseline and in response to > > > > > > > > > angiotensin II (AngII) infusion. We also sought to investigate the > > > > > > > > > relationships between aldosterone and the female sex hormones > > > > > > > > > progesterone and estradiol among women in sodium balance. Last, we > > > > > > > > > aimed to explore additional mechanisms by which female sex hormones > > > > > > > > > may modulate aldosterone production by determining whether direct > > > > > > > > > administration of progesterone or estradiol to isolated rat zona > > > > > > > > > glomerulosa (ZG) cells influences aldosterone production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > Top > > > > > > > > > Abstract > > > > > > > > > Introduction > > > > > > > > > Subjects and Methods > > > > > > > > > Results > > > > > > > > > Discussion > > > > > > > > > References > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > Subjects studied as previously described (18, 19) by the > > > > > > > > > international HyperPath (Hypertensive Pathotype) consortium were > > > > > > > > > included in this post hoc analysis. Only normotensive, premenopausal > > > > > > > > > women in sodium balance (as described in a subsequent paragraph) > > > > > > > > > were included. Subjects were excluded if they had active medical > > > > > > > > > problems, were pregnant, or were taking exogenous estrogens or > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > Normotension was defined as seated systolic b= > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2010 Report Share Posted September 19, 2010 Demo page didn't copy here is the link http://www.ehealth.va.gov/EHEALTH/CPRS_Demo.asp > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done after you ate a > lot of salt > > > > > > > > > > and was done early in menstrual cycle. You should read > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE > OF CONTENTS > > > > > > > > > > Journal of Clinical Endocrinology & Metabolism , > doi:10.1210/jc. > > > > > > > > > > 2006-1154 > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > Full Text (PDF) > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > Similar articles in this journal > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > Download to citation manager > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > Compound via MeSH > > > > > > > > > > Substance via MeSH > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > ESTRADIOL > > > > > > > > > > PROGESTERONE > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > Female Endocrinology > > > > > > > > > > The Journal of Clinical Endocrinology & Metabolism > Vol. 91, No. 10 > > > > > > > > > > 3981-3987 > > > > > > > > > > Copyright © 2006 by The Endocrine > Society > > > > > > > > > > Relationship between Aldosterone and Progesterone in > the Human > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, S. > , Dina E. > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and Ellen W. Seely > > > > > > > > > > Division of Endocrinology, Diabetes and Hypertension > (E.D.S., > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), Department of > Medicine, > > > > > > > > > > Brigham and Women's Hospital, Harvard Medical School, > Boston, > > > > > > > > > > Massachusetts 02115; and Department of Medicine > (P.N.H.), University > > > > > > > > > > of Utah School of Medicine, Salt Lake City, Utah 84132 > > > > > > > > > > > > > > > > > > > > Address all correspondence and requests for reprints > to: Ellen W. > > > > > > > > > > Seely, M.D., Division of Endocrinology, Diabetes and > Hypertension, > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood Avenue, > Boston, > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > Top > > > > > > > > > > Abstract > > > > > > > > > > Introduction > > > > > > > > > > Subjects and Methods > > > > > > > > > > Results > > > > > > > > > > Discussion > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase during the luteal > phase of the > > > > > > > > > > menstrual cycle. Prior studies examining relationships > between > > > > > > > > > > aldosterone and female sex hormones did not control > for sodium > > > > > > > > > > balance, a major determinant of aldosterone > production. > > > > > > > > > > Objectives: The objectives of this study were 1) to > compare > > > > > > > > > > aldosterone levels between menstrual phases among > cycling women in > > > > > > > > > > high- and low-sodium balance; and 2) to examine the > relationships > > > > > > > > > > between aldosterone and female sex hormones in women > and the effects > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) cell > aldosterone > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, premenopausal > women were > > > > > > > > > > studied in low- and/or high-sodium balance. Urinary > aldosterone, > > > > > > > > > > basal serum aldosterone, plasma renin activity (PRA), > plasma > > > > > > > > > > angiotensin II (AngII), and serum aldosterone after > AngII infusion > > > > > > > > > > were measured. Isolated rat ZG cells were treated with > progesterone, > > > > > > > > > > estradiol, or both, and aldosterone was measured. > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary aldosterone, > basal serum > > > > > > > > > > aldosterone, and serum aldosterone response to infused > AngII were > > > > > > > > > > significantly greater (P < 0.05) in the luteal vs. > follicular phase. > > > > > > > > > > PRA, AngII, and potassium did not differ. Progesterone > directly > > > > > > > > > > correlated with urinary aldosterone, basal serum > aldosterone, and > > > > > > > > > > serum aldosterone response to infused AngII. Estradiol > did not > > > > > > > > > > significantly correlate with aldosterone. In > low-sodium balance, no > > > > > > > > > > significant differences in aldosterone levels between > phases were > > > > > > > > > > found. In vitro, progesterone increased ZG cell > aldosterone > > > > > > > > > > production (P < 0.01), whereas estradiol had no > effect. > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum aldosterone > levels are > > > > > > > > > > significantly higher during the luteal phase in high- > but not low- > > > > > > > > > > sodium balance, whereas PRA and AngII do not differ > between phases. > > > > > > > > > > Progesterone may directly contribute to increased > luteal phase > > > > > > > > > > aldosterone production, independent of the > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > Top > > > > > > > > > > Abstract > > > > > > > > > > Introduction > > > > > > > > > > Subjects and Methods > > > > > > > > > > Results > > > > > > > > > > Discussion > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to increase > during the luteal > > > > > > > > > > phase of the human menstrual cycle, a time > characterized by > > > > > > > > > > increased progesterone and estradiol production. > Although > > > > > > > > > > progesterone is known to have antimineralocorticoid > effects (1, 2, > > > > > > > > > > 3), it is unclear whether additional mechanisms > contribute to > > > > > > > > > > increased luteal phase aldosterone production. Most > prior studies > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, 11, 12) or > document (13) > > > > > > > > > > sodium balance, which plays a major role in regulation > of > > > > > > > > > > aldosterone production via the renin-angiotensin > system (RAS). In > > > > > > > > > > two prior studies that did account for sodium balance > (14, 15), the > > > > > > > > > > relationships between aldosterone and the female sex > hormones > > > > > > > > > > progesterone and estradiol were not investigated. > > > > > > > > > > Progesterone is postulated to mediate the luteal phase > increase in > > > > > > > > > > aldosterone levels. Because progesterone inhibits > aldosterone > > > > > > > > > > binding to the mineralocorticoid receptor (1, 3, 16), > increased > > > > > > > > > > progesterone production during the luteal phase likely > leads to > > > > > > > > > > compensatory activation of the RAS and thus increased > aldosterone > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is not known > whether > > > > > > > > > > additional mechanisms contribute to luteal phase > aldosterone > > > > > > > > > > increases, independent of the RAS. We examined the > mechanisms by > > > > > > > > > > which luteal phase aldosterone levels increase among > women in sodium > > > > > > > > > > balance, because differences in sodium balance > independently > > > > > > > > > > influence RAS hormone levels. Furthermore, we > investigated the role > > > > > > > > > > of estradiol in the luteal phase aldosterone increase, > which has not > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > The purpose of this study was to compare aldosterone > levels during > > > > > > > > > > the follicular and luteal phases of the menstrual > cycle among women > > > > > > > > > > in documented sodium balance, at baseline and in > response to > > > > > > > > > > angiotensin II (AngII) infusion. We also sought to > investigate the > > > > > > > > > > relationships between aldosterone and the female sex > hormones > > > > > > > > > > progesterone and estradiol among women in sodium > balance. Last, we > > > > > > > > > > aimed to explore additional mechanisms by which female > sex hormones > > > > > > > > > > may modulate aldosterone production by determining > whether direct > > > > > > > > > > administration of progesterone or estradiol to > isolated rat zona > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > Top > > > > > > > > > > Abstract > > > > > > > > > > Introduction > > > > > > > > > > Subjects and Methods > > > > > > > > > > Results > > > > > > > > > > Discussion > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > Subjects studied as previously described (18, 19) by > the > > > > > > > > > > international HyperPath (Hypertensive Pathotype) > consortium were > > > > > > > > > > included in this post hoc analysis. Only normotensive, > premenopausal > > > > > > > > > > women in sodium balance (as described in a subsequent > paragraph) > > > > > > > > > > were included. Subjects were excluded if they had > active medical > > > > > > > > > > problems, were pregnant, or were taking exogenous > estrogens or > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated systolic b= > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2010 Report Share Posted September 19, 2010 The VistA system is public domain software, available through the Freedom Of Information Act directly from the VA website, or through a growing network of distributors. This is information I found. A few weeke ago I was looking on the VA web site and found a page where it said it could be downloaded. Also said it could be run on a Mac. It nows seems that the VA removed the full download page and only has the demo for windows. I did find one of the other distributors but only have it for windows and linux. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done after you ate a > > lot of salt > > > > > > > > > > > and was done early in menstrual cycle. You should read > > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE > > OF CONTENTS > > > > > > > > > > > Journal of Clinical Endocrinology & Metabolism , > > doi:10.1210/jc. > > > > > > > > > > > 2006-1154 > > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > Full Text (PDF) > > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > > Similar articles in this journal > > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > > Download to citation manager > > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > > Compound via MeSH > > > > > > > > > > > Substance via MeSH > > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > > ESTRADIOL > > > > > > > > > > > PROGESTERONE > > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > > Female Endocrinology > > > > > > > > > > > The Journal of Clinical Endocrinology & Metabolism > > Vol. 91, No. 10 > > > > > > > > > > > 3981-3987 > > > > > > > > > > > Copyright © 2006 by The Endocrine > > Society > > > > > > > > > > > Relationship between Aldosterone and Progesterone in > > the Human > > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, S. > > , Dina E. > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and Ellen W. Seely > > > > > > > > > > > Division of Endocrinology, Diabetes and Hypertension > > (E.D.S., > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), Department of > > Medicine, > > > > > > > > > > > Brigham and Women's Hospital, Harvard Medical School, > > Boston, > > > > > > > > > > > Massachusetts 02115; and Department of Medicine > > (P.N.H.), University > > > > > > > > > > > of Utah School of Medicine, Salt Lake City, Utah 84132 > > > > > > > > > > > > > > > > > > > > > > Address all correspondence and requests for reprints > > to: Ellen W. > > > > > > > > > > > Seely, M.D., Division of Endocrinology, Diabetes and > > Hypertension, > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood Avenue, > > Boston, > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > Top > > > > > > > > > > > Abstract > > > > > > > > > > > Introduction > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > Results > > > > > > > > > > > Discussion > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase during the luteal > > phase of the > > > > > > > > > > > menstrual cycle. Prior studies examining relationships > > between > > > > > > > > > > > aldosterone and female sex hormones did not control > > for sodium > > > > > > > > > > > balance, a major determinant of aldosterone > > production. > > > > > > > > > > > Objectives: The objectives of this study were 1) to > > compare > > > > > > > > > > > aldosterone levels between menstrual phases among > > cycling women in > > > > > > > > > > > high- and low-sodium balance; and 2) to examine the > > relationships > > > > > > > > > > > between aldosterone and female sex hormones in women > > and the effects > > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) cell > > aldosterone > > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, premenopausal > > women were > > > > > > > > > > > studied in low- and/or high-sodium balance. Urinary > > aldosterone, > > > > > > > > > > > basal serum aldosterone, plasma renin activity (PRA), > > plasma > > > > > > > > > > > angiotensin II (AngII), and serum aldosterone after > > AngII infusion > > > > > > > > > > > were measured. Isolated rat ZG cells were treated with > > progesterone, > > > > > > > > > > > estradiol, or both, and aldosterone was measured. > > > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary aldosterone, > > basal serum > > > > > > > > > > > aldosterone, and serum aldosterone response to infused > > AngII were > > > > > > > > > > > significantly greater (P < 0.05) in the luteal vs. > > follicular phase. > > > > > > > > > > > PRA, AngII, and potassium did not differ. Progesterone > > directly > > > > > > > > > > > correlated with urinary aldosterone, basal serum > > aldosterone, and > > > > > > > > > > > serum aldosterone response to infused AngII. Estradiol > > did not > > > > > > > > > > > significantly correlate with aldosterone. In > > low-sodium balance, no > > > > > > > > > > > significant differences in aldosterone levels between > > phases were > > > > > > > > > > > found. In vitro, progesterone increased ZG cell > > aldosterone > > > > > > > > > > > production (P < 0.01), whereas estradiol had no > > effect. > > > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum aldosterone > > levels are > > > > > > > > > > > significantly higher during the luteal phase in high- > > but not low- > > > > > > > > > > > sodium balance, whereas PRA and AngII do not differ > > between phases. > > > > > > > > > > > Progesterone may directly contribute to increased > > luteal phase > > > > > > > > > > > aldosterone production, independent of the > > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > Top > > > > > > > > > > > Abstract > > > > > > > > > > > Introduction > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > Results > > > > > > > > > > > Discussion > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to increase > > during the luteal > > > > > > > > > > > phase of the human menstrual cycle, a time > > characterized by > > > > > > > > > > > increased progesterone and estradiol production. > > Although > > > > > > > > > > > progesterone is known to have antimineralocorticoid > > effects (1, 2, > > > > > > > > > > > 3), it is unclear whether additional mechanisms > > contribute to > > > > > > > > > > > increased luteal phase aldosterone production. Most > > prior studies > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, 11, 12) or > > document (13) > > > > > > > > > > > sodium balance, which plays a major role in regulation > > of > > > > > > > > > > > aldosterone production via the renin-angiotensin > > system (RAS). In > > > > > > > > > > > two prior studies that did account for sodium balance > > (14, 15), the > > > > > > > > > > > relationships between aldosterone and the female sex > > hormones > > > > > > > > > > > progesterone and estradiol were not investigated. > > > > > > > > > > > Progesterone is postulated to mediate the luteal phase > > increase in > > > > > > > > > > > aldosterone levels. Because progesterone inhibits > > aldosterone > > > > > > > > > > > binding to the mineralocorticoid receptor (1, 3, 16), > > increased > > > > > > > > > > > progesterone production during the luteal phase likely > > leads to > > > > > > > > > > > compensatory activation of the RAS and thus increased > > aldosterone > > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is not known > > whether > > > > > > > > > > > additional mechanisms contribute to luteal phase > > aldosterone > > > > > > > > > > > increases, independent of the RAS. We examined the > > mechanisms by > > > > > > > > > > > which luteal phase aldosterone levels increase among > > women in sodium > > > > > > > > > > > balance, because differences in sodium balance > > independently > > > > > > > > > > > influence RAS hormone levels. Furthermore, we > > investigated the role > > > > > > > > > > > of estradiol in the luteal phase aldosterone increase, > > which has not > > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > > > The purpose of this study was to compare aldosterone > > levels during > > > > > > > > > > > the follicular and luteal phases of the menstrual > > cycle among women > > > > > > > > > > > in documented sodium balance, at baseline and in > > response to > > > > > > > > > > > angiotensin II (AngII) infusion. We also sought to > > investigate the > > > > > > > > > > > relationships between aldosterone and the female sex > > hormones > > > > > > > > > > > progesterone and estradiol among women in sodium > > balance. Last, we > > > > > > > > > > > aimed to explore additional mechanisms by which female > > sex hormones > > > > > > > > > > > may modulate aldosterone production by determining > > whether direct > > > > > > > > > > > administration of progesterone or estradiol to > > isolated rat zona > > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone > > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > Top > > > > > > > > > > > Abstract > > > > > > > > > > > Introduction > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > Results > > > > > > > > > > > Discussion > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > > Subjects studied as previously described (18, 19) by > > the > > > > > > > > > > > international HyperPath (Hypertensive Pathotype) > > consortium were > > > > > > > > > > > included in this post hoc analysis. Only normotensive, > > premenopausal > > > > > > > > > > > women in sodium balance (as described in a subsequent > > paragraph) > > > > > > > > > > > were included. Subjects were excluded if they had > > active medical > > > > > > > > > > > problems, were pregnant, or were taking exogenous > > estrogens or > > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated systolic b= > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 20, 2010 Report Share Posted September 20, 2010 My guess is while you are working at the VA you won't have much free time. At least what I am told about the VA I go to is the Dr that do all they have to do work up 12 hr a day. Some don't so other Dr have to what others don't. I do know that most of time during my visits the dr is writing notes or looking for information. This makes it hard for Dr to give full time to respond to questions. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done after you ate a > > > lot of salt > > > > > > > > > > > > and was done early in menstrual cycle. You should read > > > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE > > > OF CONTENTS > > > > > > > > > > > > Journal of Clinical Endocrinology & Metabolism , > > > doi:10.1210/jc. > > > > > > > > > > > > 2006-1154 > > > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > Full Text (PDF) > > > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > > > Similar articles in this journal > > > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > > > Download to citation manager > > > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > > > Compound via MeSH > > > > > > > > > > > > Substance via MeSH > > > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > > > ESTRADIOL > > > > > > > > > > > > PROGESTERONE > > > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > > > Female Endocrinology > > > > > > > > > > > > The Journal of Clinical Endocrinology & Metabolism > > > Vol. 91, No. 10 > > > > > > > > > > > > 3981-3987 > > > > > > > > > > > > Copyright © 2006 by The Endocrine > > > Society > > > > > > > > > > > > Relationship between Aldosterone and Progesterone in > > > the Human > > > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, S. > > > , Dina E. > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and Ellen W. Seely > > > > > > > > > > > > Division of Endocrinology, Diabetes and Hypertension > > > (E.D.S., > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), Department of > > > Medicine, > > > > > > > > > > > > Brigham and Women's Hospital, Harvard Medical School, > > > Boston, > > > > > > > > > > > > Massachusetts 02115; and Department of Medicine > > > (P.N.H.), University > > > > > > > > > > > > of Utah School of Medicine, Salt Lake City, Utah 84132 > > > > > > > > > > > > > > > > > > > > > > > > Address all correspondence and requests for reprints > > > to: Ellen W. > > > > > > > > > > > > Seely, M.D., Division of Endocrinology, Diabetes and > > > Hypertension, > > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood Avenue, > > > Boston, > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > Top > > > > > > > > > > > > Abstract > > > > > > > > > > > > Introduction > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > Results > > > > > > > > > > > > Discussion > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase during the luteal > > > phase of the > > > > > > > > > > > > menstrual cycle. Prior studies examining relationships > > > between > > > > > > > > > > > > aldosterone and female sex hormones did not control > > > for sodium > > > > > > > > > > > > balance, a major determinant of aldosterone > > > production. > > > > > > > > > > > > Objectives: The objectives of this study were 1) to > > > compare > > > > > > > > > > > > aldosterone levels between menstrual phases among > > > cycling women in > > > > > > > > > > > > high- and low-sodium balance; and 2) to examine the > > > relationships > > > > > > > > > > > > between aldosterone and female sex hormones in women > > > and the effects > > > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) cell > > > aldosterone > > > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, premenopausal > > > women were > > > > > > > > > > > > studied in low- and/or high-sodium balance. Urinary > > > aldosterone, > > > > > > > > > > > > basal serum aldosterone, plasma renin activity (PRA), > > > plasma > > > > > > > > > > > > angiotensin II (AngII), and serum aldosterone after > > > AngII infusion > > > > > > > > > > > > were measured. Isolated rat ZG cells were treated with > > > progesterone, > > > > > > > > > > > > estradiol, or both, and aldosterone was measured. > > > > > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary aldosterone, > > > basal serum > > > > > > > > > > > > aldosterone, and serum aldosterone response to infused > > > AngII were > > > > > > > > > > > > significantly greater (P < 0.05) in the luteal vs. > > > follicular phase. > > > > > > > > > > > > PRA, AngII, and potassium did not differ. Progesterone > > > directly > > > > > > > > > > > > correlated with urinary aldosterone, basal serum > > > aldosterone, and > > > > > > > > > > > > serum aldosterone response to infused AngII. Estradiol > > > did not > > > > > > > > > > > > significantly correlate with aldosterone. In > > > low-sodium balance, no > > > > > > > > > > > > significant differences in aldosterone levels between > > > phases were > > > > > > > > > > > > found. In vitro, progesterone increased ZG cell > > > aldosterone > > > > > > > > > > > > production (P < 0.01), whereas estradiol had no > > > effect. > > > > > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum aldosterone > > > levels are > > > > > > > > > > > > significantly higher during the luteal phase in high- > > > but not low- > > > > > > > > > > > > sodium balance, whereas PRA and AngII do not differ > > > between phases. > > > > > > > > > > > > Progesterone may directly contribute to increased > > > luteal phase > > > > > > > > > > > > aldosterone production, independent of the > > > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > Top > > > > > > > > > > > > Abstract > > > > > > > > > > > > Introduction > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > Results > > > > > > > > > > > > Discussion > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to increase > > > during the luteal > > > > > > > > > > > > phase of the human menstrual cycle, a time > > > characterized by > > > > > > > > > > > > increased progesterone and estradiol production. > > > Although > > > > > > > > > > > > progesterone is known to have antimineralocorticoid > > > effects (1, 2, > > > > > > > > > > > > 3), it is unclear whether additional mechanisms > > > contribute to > > > > > > > > > > > > increased luteal phase aldosterone production. Most > > > prior studies > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, 11, 12) or > > > document (13) > > > > > > > > > > > > sodium balance, which plays a major role in regulation > > > of > > > > > > > > > > > > aldosterone production via the renin-angiotensin > > > system (RAS). In > > > > > > > > > > > > two prior studies that did account for sodium balance > > > (14, 15), the > > > > > > > > > > > > relationships between aldosterone and the female sex > > > hormones > > > > > > > > > > > > progesterone and estradiol were not investigated. > > > > > > > > > > > > Progesterone is postulated to mediate the luteal phase > > > increase in > > > > > > > > > > > > aldosterone levels. Because progesterone inhibits > > > aldosterone > > > > > > > > > > > > binding to the mineralocorticoid receptor (1, 3, 16), > > > increased > > > > > > > > > > > > progesterone production during the luteal phase likely > > > leads to > > > > > > > > > > > > compensatory activation of the RAS and thus increased > > > aldosterone > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is not known > > > whether > > > > > > > > > > > > additional mechanisms contribute to luteal phase > > > aldosterone > > > > > > > > > > > > increases, independent of the RAS. We examined the > > > mechanisms by > > > > > > > > > > > > which luteal phase aldosterone levels increase among > > > women in sodium > > > > > > > > > > > > balance, because differences in sodium balance > > > independently > > > > > > > > > > > > influence RAS hormone levels. Furthermore, we > > > investigated the role > > > > > > > > > > > > of estradiol in the luteal phase aldosterone increase, > > > which has not > > > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > > > > > The purpose of this study was to compare aldosterone > > > levels during > > > > > > > > > > > > the follicular and luteal phases of the menstrual > > > cycle among women > > > > > > > > > > > > in documented sodium balance, at baseline and in > > > response to > > > > > > > > > > > > angiotensin II (AngII) infusion. We also sought to > > > investigate the > > > > > > > > > > > > relationships between aldosterone and the female sex > > > hormones > > > > > > > > > > > > progesterone and estradiol among women in sodium > > > balance. Last, we > > > > > > > > > > > > aimed to explore additional mechanisms by which female > > > sex hormones > > > > > > > > > > > > may modulate aldosterone production by determining > > > whether direct > > > > > > > > > > > > administration of progesterone or estradiol to > > > isolated rat zona > > > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone > > > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > Top > > > > > > > > > > > > Abstract > > > > > > > > > > > > Introduction > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > Results > > > > > > > > > > > > Discussion > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > > > Subjects studied as previously described (18, 19) by > > > the > > > > > > > > > > > > international HyperPath (Hypertensive Pathotype) > > > consortium were > > > > > > > > > > > > included in this post hoc analysis. Only normotensive, > > > premenopausal > > > > > > > > > > > > women in sodium balance (as described in a subsequent > > > paragraph) > > > > > > > > > > > > were included. Subjects were excluded if they had > > > active medical > > > > > > > > > > > > problems, were pregnant, or were taking exogenous > > > estrogens or > > > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated systolic b= > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 20, 2010 Report Share Posted September 20, 2010 I am and 8-5 Dr. in an clinic in the country. Takes only scheduled pts. Will give you can update.CE Grim MDOn Sep 20, 2010, at 7:47 AM, Francis Bill SUSPECTED PA wrote:My guess is while you are working at the VA you won't have much free time. At least what I am told about the VA I go to is the Dr that do all they have to do work up 12 hr a day. Some don't so other Dr have to what others don't. I do know that most of time during my visits the dr is writing notes or looking for information. This makes it hard for Dr to give full time to respond to questions. > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > Since you say this aldo/renin was done after you ate a> > > lot of salt> > > > > > > > > > > > and was done early in menstrual cycle. You should read> > > this study.> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE> > > OF CONTENTS> > > > > > > > > > > > Journal of Clinical Endocrinology & Metabolism ,> > > doi:10.1210/jc.> > > > > > > > > > > > 2006-1154> > > > > > > > > > > > This Article> > > > > > > > > > > >> > > > > > > > > > > > Abstract> > > > > > > > > > > > Full Text (PDF)> > > > > > > > > > > > Submit a related Letter to the Editor> > > > > > > > > > > > Alert me when this article is cited> > > > > > > > > > > > Alert me when eLetters are posted> > > > > > > > > > > > Alert me if a correction is posted> > > > > > > > > > > > Citation Map> > > > > > > > > > > >> > > > > > > > > > > > Services> > > > > > > > > > > >> > > > > > > > > > > > Email this article to a friend> > > > > > > > > > > > Similar articles in this journal> > > > > > > > > > > > Similar articles in PubMed> > > > > > > > > > > > Alert me to new issues of the journal> > > > > > > > > > > > Download to citation manager> > > > > > > > > > > > Reprints, Permissions and Rights> > > > > > > > > > > >> > > > > > > > > > > > Citing Articles> > > > > > > > > > > >> > > > > > > > > > > > Citing Articles via HighWire> > > > > > > > > > > > Citing Articles via Google Scholar> > > > > > > > > > > >> > > > > > > > > > > > Google Scholar> > > > > > > > > > > >> > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > Search for Related Content> > > > > > > > > > > >> > > > > > > > > > > > PubMed> > > > > > > > > > > >> > > > > > > > > > > > PubMed Citation> > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > Pubmed/NCBI databases> > > > > > > > > > > > Compound via MeSH> > > > > > > > > > > > Substance via MeSH> > > > > > > > > > > > Hazardous Substances DB> > > > > > > > > > > > ESTRADIOL> > > > > > > > > > > > PROGESTERONE> > > > > > > > > > > > SODIUM> > > > > > > > > > > >> > > > > > > > > > > > Related Collections> > > > > > > > > > > >> > > > > > > > > > > > Adrenal and Hypertension> > > > > > > > > > > > Female Endocrinology> > > > > > > > > > > > The Journal of Clinical Endocrinology & Metabolism> > > Vol. 91, No. 10> > > > > > > > > > > > 3981-3987> > > > > > > > > > > > Copyright © 2006 by The Endocrine> > > Society> > > > > > > > > > > > Relationship between Aldosterone and Progesterone in> > > the Human> > > > > > > > > > > > Menstrual Cycle> > > > > > > > > > > >> > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, S.> > > , Dina E.> > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and Ellen W. Seely> > > > > > > > > > > > Division of Endocrinology, Diabetes and Hypertension> > > (E.D.S.,> > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), Department of> > > Medicine,> > > > > > > > > > > > Brigham and Women's Hospital, Harvard Medical School,> > > Boston,> > > > > > > > > > > > Massachusetts 02115; and Department of Medicine> > > (P.N.H.), University> > > > > > > > > > > > of Utah School of Medicine, Salt Lake City, Utah 84132> > > > > > > > > > > >> > > > > > > > > > > > Address all correspondence and requests for reprints> > > to: Ellen W.> > > > > > > > > > > > Seely, M.D., Division of Endocrinology, Diabetes and> > > Hypertension,> > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood Avenue,> > > Boston,> > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ .> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > Abstract> > > > > > > > > > > > Top> > > > > > > > > > > > Abstract> > > > > > > > > > > > Introduction> > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > Results> > > > > > > > > > > > Discussion> > > > > > > > > > > > References> > > > > > > > > > > >> > > > > > > > > > > > Context: Aldosterone levels increase during the luteal> > > phase of the> > > > > > > > > > > > menstrual cycle. Prior studies examining relationships> > > between> > > > > > > > > > > > aldosterone and female sex hormones did not control> > > for sodium> > > > > > > > > > > > balance, a major determinant of aldosterone> > > production.> > > > > > > > > > > > Objectives: The objectives of this study were 1) to> > > compare> > > > > > > > > > > > aldosterone levels between menstrual phases among> > > cycling women in> > > > > > > > > > > > high- and low-sodium balance; and 2) to examine the> > > relationships> > > > > > > > > > > > between aldosterone and female sex hormones in women> > > and the effects> > > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) cell> > > aldosterone> > > > > > > > > > > > production in vitro.> > > > > > > > > > > >> > > > > > > > > > > > Subjects/Interventions: Normotensive, premenopausal> > > women were> > > > > > > > > > > > studied in low- and/or high-sodium balance. Urinary> > > aldosterone,> > > > > > > > > > > > basal serum aldosterone, plasma renin activity (PRA),> > > plasma> > > > > > > > > > > > angiotensin II (AngII), and serum aldosterone after> > > AngII infusion> > > > > > > > > > > > were measured. Isolated rat ZG cells were treated with> > > progesterone,> > > > > > > > > > > > estradiol, or both, and aldosterone was measured.> > > > > > > > > > > >> > > > > > > > > > > > Results: In high-sodium balance, urinary aldosterone,> > > basal serum> > > > > > > > > > > > aldosterone, and serum aldosterone response to infused> > > AngII were> > > > > > > > > > > > significantly greater (P < 0.05) in the luteal vs.> > > follicular phase.> > > > > > > > > > > > PRA, AngII, and potassium did not differ. Progesterone> > > directly> > > > > > > > > > > > correlated with urinary aldosterone, basal serum> > > aldosterone, and> > > > > > > > > > > > serum aldosterone response to infused AngII. Estradiol> > > did not> > > > > > > > > > > > significantly correlate with aldosterone. In> > > low-sodium balance, no> > > > > > > > > > > > significant differences in aldosterone levels between> > > phases were> > > > > > > > > > > > found. In vitro, progesterone increased ZG cell> > > aldosterone> > > > > > > > > > > > production (P < 0.01), whereas estradiol had no> > > effect.> > > > > > > > > > > >> > > > > > > > > > > > Conclusions: In women, urinary and serum aldosterone> > > levels are> > > > > > > > > > > > significantly higher during the luteal phase in high-> > > but not low-> > > > > > > > > > > > sodium balance, whereas PRA and AngII do not differ> > > between phases.> > > > > > > > > > > > Progesterone may directly contribute to increased> > > luteal phase> > > > > > > > > > > > aldosterone production, independent of the> > > renin-angiotensin system.> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > Introduction> > > > > > > > > > > > Top> > > > > > > > > > > > Abstract> > > > > > > > > > > > Introduction> > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > Results> > > > > > > > > > > > Discussion> > > > > > > > > > > > References> > > > > > > > > > > >> > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to increase> > > during the luteal> > > > > > > > > > > > phase of the human menstrual cycle, a time> > > characterized by> > > > > > > > > > > > increased progesterone and estradiol production.> > > Although> > > > > > > > > > > > progesterone is known to have antimineralocorticoid> > > effects (1, 2,> > > > > > > > > > > > 3), it is unclear whether additional mechanisms> > > contribute to> > > > > > > > > > > > increased luteal phase aldosterone production. Most> > > prior studies> > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, 11, 12) or> > > document (13)> > > > > > > > > > > > sodium balance, which plays a major role in regulation> > > of> > > > > > > > > > > > aldosterone production via the renin-angiotensin> > > system (RAS). In> > > > > > > > > > > > two prior studies that did account for sodium balance> > > (14, 15), the> > > > > > > > > > > > relationships between aldosterone and the female sex> > > hormones> > > > > > > > > > > > progesterone and estradiol were not investigated.> > > > > > > > > > > > Progesterone is postulated to mediate the luteal phase> > > increase in> > > > > > > > > > > > aldosterone levels. Because progesterone inhibits> > > aldosterone> > > > > > > > > > > > binding to the mineralocorticoid receptor (1, 3, 16),> > > increased> > > > > > > > > > > > progesterone production during the luteal phase likely> > > leads to> > > > > > > > > > > > compensatory activation of the RAS and thus increased> > > aldosterone> > > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is not known> > > whether> > > > > > > > > > > > additional mechanisms contribute to luteal phase> > > aldosterone> > > > > > > > > > > > increases, independent of the RAS. We examined the> > > mechanisms by> > > > > > > > > > > > which luteal phase aldosterone levels increase among> > > women in sodium> > > > > > > > > > > > balance, because differences in sodium balance> > > independently> > > > > > > > > > > > influence RAS hormone levels. Furthermore, we> > > investigated the role> > > > > > > > > > > > of estradiol in the luteal phase aldosterone increase,> > > which has not> > > > > > > > > > > > been previously reported.> > > > > > > > > > > >> > > > > > > > > > > > The purpose of this study was to compare aldosterone> > > levels during> > > > > > > > > > > > the follicular and luteal phases of the menstrual> > > cycle among women> > > > > > > > > > > > in documented sodium balance, at baseline and in> > > response to> > > > > > > > > > > > angiotensin II (AngII) infusion. We also sought to> > > investigate the> > > > > > > > > > > > relationships between aldosterone and the female sex> > > hormones> > > > > > > > > > > > progesterone and estradiol among women in sodium> > > balance. Last, we> > > > > > > > > > > > aimed to explore additional mechanisms by which female> > > sex hormones> > > > > > > > > > > > may modulate aldosterone production by determining> > > whether direct> > > > > > > > > > > > administration of progesterone or estradiol to> > > isolated rat zona> > > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone> > > production.> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > >> > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > Top> > > > > > > > > > > > Abstract> > > > > > > > > > > > Introduction> > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > Results> > > > > > > > > > > > Discussion> > > > > > > > > > > > References> > > > > > > > > > > >> > > > > > > > > > > > Subjects> > > > > > > > > > > > Subjects studied as previously described (18, 19) by> > > the> > > > > > > > > > > > international HyperPath (Hypertensive Pathotype)> > > consortium were> > > > > > > > > > > > included in this post hoc analysis. Only normotensive,> > > premenopausal> > > > > > > > > > > > women in sodium balance (as described in a subsequent> > > paragraph)> > > > > > > > > > > > were included. Subjects were excluded if they had> > > active medical> > > > > > > > > > > > problems, were pregnant, or were taking exogenous> > > estrogens or> > > > > > > > > > > > progestins.> > > > > > > > > > > >> > > > > > > > > > > > Normotension was defined as seated systolic b=> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2010 Report Share Posted September 21, 2010 My nephew who was working at this VA is one of the reasons VA Dr's are now over worked. He is in the National Guard. He spent one tour in Iraq. He is now starting a tour in Kuwait. Hopefully this will be a more peaceful tour. This is going to be the start of withdrawing troops from Iraq. So his duty is going to be to process the troops. Since his job was to field calls from vets that would call the VA for things like RX renewals and request to talk to there Dr. He found that some of the Dr did not return calls of renew RX. most did not have time to do this during the 8 to 5 shift. the ones that did the call backs and RX renewals did it after 5 and some would spend 3 to 4 hours a day doing this. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done after > > you ate a > > > > > lot of salt > > > > > > > > > > > > > > and was done early in menstrual cycle. You > > should read > > > > > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE > > SEARCH TABLE > > > > > OF CONTENTS > > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > Metabolism , > > > > > doi:10.1210/jc. > > > > > > > > > > > > > > 2006-1154 > > > > > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > Full Text (PDF) > > > > > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > > > > > Similar articles in this journal > > > > > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > > > > > Download to citation manager > > > > > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > > > > > Compound via MeSH > > > > > > > > > > > > > > Substance via MeSH > > > > > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > > > > > ESTRADIOL > > > > > > > > > > > > > > PROGESTERONE > > > > > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > > > > > Female Endocrinology > > > > > > > > > > > > > > The Journal of Clinical Endocrinology & > > Metabolism > > > > > Vol. 91, No. 10 > > > > > > > > > > > > > > 3981-3987 > > > > > > > > > > > > > > Copyright © 2006 by The Endocrine > > > > > Society > > > > > > > > > > > > > > Relationship between Aldosterone and > > Progesterone in > > > > > the Human > > > > > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, > > S. > > > > > , Dina E. > > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and > > Ellen W. Seely > > > > > > > > > > > > > > Division of Endocrinology, Diabetes and > > Hypertension > > > > > (E.D.S., > > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), > > Department of > > > > > Medicine, > > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard > > Medical School, > > > > > Boston, > > > > > > > > > > > > > > Massachusetts 02115; and Department of > > Medicine > > > > > (P.N.H.), University > > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake City, > > Utah 84132 > > > > > > > > > > > > > > > > > > > > > > > > > > > > Address all correspondence and requests for > > reprints > > > > > to: Ellen W. > > > > > > > > > > > > > > Seely, M.D., Division of Endocrinology, > > Diabetes and > > > > > Hypertension, > > > > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood > > Avenue, > > > > > Boston, > > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase during > > the luteal > > > > > phase of the > > > > > > > > > > > > > > menstrual cycle. Prior studies examining > > relationships > > > > > between > > > > > > > > > > > > > > aldosterone and female sex hormones did not > > control > > > > > for sodium > > > > > > > > > > > > > > balance, a major determinant of aldosterone > > > > > production. > > > > > > > > > > > > > > Objectives: The objectives of this study > > were 1) to > > > > > compare > > > > > > > > > > > > > > aldosterone levels between menstrual phases > > among > > > > > cycling women in > > > > > > > > > > > > > > high- and low-sodium balance; and 2) to > > examine the > > > > > relationships > > > > > > > > > > > > > > between aldosterone and female sex hormones > > in women > > > > > and the effects > > > > > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) > > cell > > > > > aldosterone > > > > > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, > > premenopausal > > > > > women were > > > > > > > > > > > > > > studied in low- and/or high-sodium balance. > > Urinary > > > > > aldosterone, > > > > > > > > > > > > > > basal serum aldosterone, plasma renin > > activity (PRA), > > > > > plasma > > > > > > > > > > > > > > angiotensin II (AngII), and serum > > aldosterone after > > > > > AngII infusion > > > > > > > > > > > > > > were measured. Isolated rat ZG cells were > > treated with > > > > > progesterone, > > > > > > > > > > > > > > estradiol, or both, and aldosterone was > > measured. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary > > aldosterone, > > > > > basal serum > > > > > > > > > > > > > > aldosterone, and serum aldosterone response > > to infused > > > > > AngII were > > > > > > > > > > > > > > significantly greater (P < 0.05) in the > > luteal vs. > > > > > follicular phase. > > > > > > > > > > > > > > PRA, AngII, and potassium did not differ. > > Progesterone > > > > > directly > > > > > > > > > > > > > > correlated with urinary aldosterone, basal > > serum > > > > > aldosterone, and > > > > > > > > > > > > > > serum aldosterone response to infused AngII. > > Estradiol > > > > > did not > > > > > > > > > > > > > > significantly correlate with aldosterone. In > > > > > low-sodium balance, no > > > > > > > > > > > > > > significant differences in aldosterone > > levels between > > > > > phases were > > > > > > > > > > > > > > found. In vitro, progesterone increased ZG > > cell > > > > > aldosterone > > > > > > > > > > > > > > production (P < 0.01), whereas estradiol had > > no > > > > > effect. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum > > aldosterone > > > > > levels are > > > > > > > > > > > > > > significantly higher during the luteal phase > > in high- > > > > > but not low- > > > > > > > > > > > > > > sodium balance, whereas PRA and AngII do not > > differ > > > > > between phases. > > > > > > > > > > > > > > Progesterone may directly contribute to > > increased > > > > > luteal phase > > > > > > > > > > > > > > aldosterone production, independent of the > > > > > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to > > increase > > > > > during the luteal > > > > > > > > > > > > > > phase of the human menstrual cycle, a time > > > > > characterized by > > > > > > > > > > > > > > increased progesterone and estradiol > > production. > > > > > Although > > > > > > > > > > > > > > progesterone is known to have > > antimineralocorticoid > > > > > effects (1, 2, > > > > > > > > > > > > > > 3), it is unclear whether additional > > mechanisms > > > > > contribute to > > > > > > > > > > > > > > increased luteal phase aldosterone > > production. Most > > > > > prior studies > > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, > > 11, 12) or > > > > > document (13) > > > > > > > > > > > > > > sodium balance, which plays a major role in > > regulation > > > > > of > > > > > > > > > > > > > > aldosterone production via the renin- > > angiotensin > > > > > system (RAS). In > > > > > > > > > > > > > > two prior studies that did account for > > sodium balance > > > > > (14, 15), the > > > > > > > > > > > > > > relationships between aldosterone and the > > female sex > > > > > hormones > > > > > > > > > > > > > > progesterone and estradiol were not > > investigated. > > > > > > > > > > > > > > Progesterone is postulated to mediate the > > luteal phase > > > > > increase in > > > > > > > > > > > > > > aldosterone levels. Because progesterone > > inhibits > > > > > aldosterone > > > > > > > > > > > > > > binding to the mineralocorticoid receptor > > (1, 3, 16), > > > > > increased > > > > > > > > > > > > > > progesterone production during the luteal > > phase likely > > > > > leads to > > > > > > > > > > > > > > compensatory activation of the RAS and thus > > increased > > > > > aldosterone > > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is > > not known > > > > > whether > > > > > > > > > > > > > > additional mechanisms contribute to luteal > > phase > > > > > aldosterone > > > > > > > > > > > > > > increases, independent of the RAS. We > > examined the > > > > > mechanisms by > > > > > > > > > > > > > > which luteal phase aldosterone levels > > increase among > > > > > women in sodium > > > > > > > > > > > > > > balance, because differences in sodium balance > > > > > independently > > > > > > > > > > > > > > influence RAS hormone levels. Furthermore, we > > > > > investigated the role > > > > > > > > > > > > > > of estradiol in the luteal phase aldosterone > > increase, > > > > > which has not > > > > > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > > > > > > > > > The purpose of this study was to compare > > aldosterone > > > > > levels during > > > > > > > > > > > > > > the follicular and luteal phases of the > > menstrual > > > > > cycle among women > > > > > > > > > > > > > > in documented sodium balance, at baseline > > and in > > > > > response to > > > > > > > > > > > > > > angiotensin II (AngII) infusion. We also > > sought to > > > > > investigate the > > > > > > > > > > > > > > relationships between aldosterone and the > > female sex > > > > > hormones > > > > > > > > > > > > > > progesterone and estradiol among women in > > sodium > > > > > balance. Last, we > > > > > > > > > > > > > > aimed to explore additional mechanisms by > > which female > > > > > sex hormones > > > > > > > > > > > > > > may modulate aldosterone production by > > determining > > > > > whether direct > > > > > > > > > > > > > > administration of progesterone or estradiol to > > > > > isolated rat zona > > > > > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone > > > > > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > > > > > Subjects studied as previously described > > (18, 19) by > > > > > the > > > > > > > > > > > > > > international HyperPath (Hypertensive > > Pathotype) > > > > > consortium were > > > > > > > > > > > > > > included in this post hoc analysis. Only > > normotensive, > > > > > premenopausal > > > > > > > > > > > > > > women in sodium balance (as described in a > > subsequent > > > > > paragraph) > > > > > > > > > > > > > > were included. Subjects were excluded if > > they had > > > > > active medical > > > > > > > > > > > > > > problems, were pregnant, or were taking > > exogenous > > > > > estrogens or > > > > > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated systolic b= > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2010 Report Share Posted September 21, 2010 I have an 8-5 contract. So will work those hours.Also they don't pay that much.CE Grim MDOn Sep 21, 2010, at 7:06 PM, Francis Bill SUSPECTED PA wrote:My nephew who was working at this VA is one of the reasons VA Dr's are now over worked. He is in the National Guard. He spent one tour in Iraq. He is now starting a tour in Kuwait. Hopefully this will be a more peaceful tour. This is going to be the start of withdrawing troops from Iraq. So his duty is going to be to process the troops. Since his job was to field calls from vets that would call the VA for things like RX renewals and request to talk to there Dr. He found that some of the Dr did not return calls of renew RX. most did not have time to do this during the 8 to 5 shift. the ones that did the call backs and RX renewals did it after 5 and some would spend 3 to 4 hours a day doing this. > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > Since you say this aldo/renin was done after > > you ate a> > > > > lot of salt> > > > > > > > > > > > > > and was done early in menstrual cycle. You > > should read> > > > > this study.> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE > > SEARCH TABLE> > > > > OF CONTENTS> > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > Metabolism ,> > > > > doi:10.1210/jc.> > > > > > > > > > > > > > 2006-1154> > > > > > > > > > > > > > This Article> > > > > > > > > > > > > >> > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > Full Text (PDF)> > > > > > > > > > > > > > Submit a related Letter to the Editor> > > > > > > > > > > > > > Alert me when this article is cited> > > > > > > > > > > > > > Alert me when eLetters are posted> > > > > > > > > > > > > > Alert me if a correction is posted> > > > > > > > > > > > > > Citation Map> > > > > > > > > > > > > >> > > > > > > > > > > > > > Services> > > > > > > > > > > > > >> > > > > > > > > > > > > > Email this article to a friend> > > > > > > > > > > > > > Similar articles in this journal> > > > > > > > > > > > > > Similar articles in PubMed> > > > > > > > > > > > > > Alert me to new issues of the journal> > > > > > > > > > > > > > Download to citation manager> > > > > > > > > > > > > > Reprints, Permissions and Rights> > > > > > > > > > > > > >> > > > > > > > > > > > > > Citing Articles> > > > > > > > > > > > > >> > > > > > > > > > > > > > Citing Articles via HighWire> > > > > > > > > > > > > > Citing Articles via Google Scholar> > > > > > > > > > > > > >> > > > > > > > > > > > > > Google Scholar> > > > > > > > > > > > > >> > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > Search for Related Content> > > > > > > > > > > > > >> > > > > > > > > > > > > > PubMed> > > > > > > > > > > > > >> > > > > > > > > > > > > > PubMed Citation> > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > Pubmed/NCBI databases> > > > > > > > > > > > > > Compound via MeSH> > > > > > > > > > > > > > Substance via MeSH> > > > > > > > > > > > > > Hazardous Substances DB> > > > > > > > > > > > > > ESTRADIOL> > > > > > > > > > > > > > PROGESTERONE> > > > > > > > > > > > > > SODIUM> > > > > > > > > > > > > >> > > > > > > > > > > > > > Related Collections> > > > > > > > > > > > > >> > > > > > > > > > > > > > Adrenal and Hypertension> > > > > > > > > > > > > > Female Endocrinology> > > > > > > > > > > > > > The Journal of Clinical Endocrinology & > > Metabolism> > > > > Vol. 91, No. 10> > > > > > > > > > > > > > 3981-3987> > > > > > > > > > > > > > Copyright © 2006 by The Endocrine> > > > > Society> > > > > > > > > > > > > > Relationship between Aldosterone and > > Progesterone in> > > > > the Human> > > > > > > > > > > > > > Menstrual Cycle> > > > > > > > > > > > > >> > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, > > S.> > > > > , Dina E.> > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and > > Ellen W. Seely> > > > > > > > > > > > > > Division of Endocrinology, Diabetes and > > Hypertension> > > > > (E.D.S.,> > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), > > Department of> > > > > Medicine,> > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard > > Medical School,> > > > > Boston,> > > > > > > > > > > > > > Massachusetts 02115; and Department of > > Medicine> > > > > (P.N.H.), University> > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake City, > > Utah 84132> > > > > > > > > > > > > >> > > > > > > > > > > > > > Address all correspondence and requests for > > reprints> > > > > to: Ellen W.> > > > > > > > > > > > > > Seely, M.D., Division of Endocrinology, > > Diabetes and> > > > > Hypertension,> > > > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood > > Avenue,> > > > > Boston,> > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ .> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > Top> > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > Results> > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > References> > > > > > > > > > > > > >> > > > > > > > > > > > > > Context: Aldosterone levels increase during > > the luteal> > > > > phase of the> > > > > > > > > > > > > > menstrual cycle. Prior studies examining > > relationships> > > > > between> > > > > > > > > > > > > > aldosterone and female sex hormones did not > > control> > > > > for sodium> > > > > > > > > > > > > > balance, a major determinant of aldosterone> > > > > production.> > > > > > > > > > > > > > Objectives: The objectives of this study > > were 1) to> > > > > compare> > > > > > > > > > > > > > aldosterone levels between menstrual phases > > among> > > > > cycling women in> > > > > > > > > > > > > > high- and low-sodium balance; and 2) to > > examine the> > > > > relationships> > > > > > > > > > > > > > between aldosterone and female sex hormones > > in women> > > > > and the effects> > > > > > > > > > > > > > of sex hormones on rat zona glomerulosa (ZG) > > cell> > > > > aldosterone> > > > > > > > > > > > > > production in vitro.> > > > > > > > > > > > > >> > > > > > > > > > > > > > Subjects/Interventions: Normotensive, > > premenopausal> > > > > women were> > > > > > > > > > > > > > studied in low- and/or high-sodium balance. > > Urinary> > > > > aldosterone,> > > > > > > > > > > > > > basal serum aldosterone, plasma renin > > activity (PRA),> > > > > plasma> > > > > > > > > > > > > > angiotensin II (AngII), and serum > > aldosterone after> > > > > AngII infusion> > > > > > > > > > > > > > were measured. Isolated rat ZG cells were > > treated with> > > > > progesterone,> > > > > > > > > > > > > > estradiol, or both, and aldosterone was > > measured.> > > > > > > > > > > > > >> > > > > > > > > > > > > > Results: In high-sodium balance, urinary > > aldosterone,> > > > > basal serum> > > > > > > > > > > > > > aldosterone, and serum aldosterone response > > to infused> > > > > AngII were> > > > > > > > > > > > > > significantly greater (P < 0.05) in the > > luteal vs.> > > > > follicular phase.> > > > > > > > > > > > > > PRA, AngII, and potassium did not differ. > > Progesterone> > > > > directly> > > > > > > > > > > > > > correlated with urinary aldosterone, basal > > serum> > > > > aldosterone, and> > > > > > > > > > > > > > serum aldosterone response to infused AngII. > > Estradiol> > > > > did not> > > > > > > > > > > > > > significantly correlate with aldosterone. In> > > > > low-sodium balance, no> > > > > > > > > > > > > > significant differences in aldosterone > > levels between> > > > > phases were> > > > > > > > > > > > > > found. In vitro, progesterone increased ZG > > cell> > > > > aldosterone> > > > > > > > > > > > > > production (P < 0.01), whereas estradiol had > > no> > > > > effect.> > > > > > > > > > > > > >> > > > > > > > > > > > > > Conclusions: In women, urinary and serum > > aldosterone> > > > > levels are> > > > > > > > > > > > > > significantly higher during the luteal phase > > in high-> > > > > but not low-> > > > > > > > > > > > > > sodium balance, whereas PRA and AngII do not > > differ> > > > > between phases.> > > > > > > > > > > > > > Progesterone may directly contribute to > > increased> > > > > luteal phase> > > > > > > > > > > > > > aldosterone production, independent of the> > > > > renin-angiotensin system.> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > Top> > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > Results> > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > References> > > > > > > > > > > > > >> > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to > > increase> > > > > during the luteal> > > > > > > > > > > > > > phase of the human menstrual cycle, a time> > > > > characterized by> > > > > > > > > > > > > > increased progesterone and estradiol > > production.> > > > > Although> > > > > > > > > > > > > > progesterone is known to have > > antimineralocorticoid> > > > > effects (1, 2,> > > > > > > > > > > > > > 3), it is unclear whether additional > > mechanisms> > > > > contribute to> > > > > > > > > > > > > > increased luteal phase aldosterone > > production. Most> > > > > prior studies> > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, > > 11, 12) or> > > > > document (13)> > > > > > > > > > > > > > sodium balance, which plays a major role in > > regulation> > > > > of> > > > > > > > > > > > > > aldosterone production via the renin- > > angiotensin> > > > > system (RAS). In> > > > > > > > > > > > > > two prior studies that did account for > > sodium balance> > > > > (14, 15), the> > > > > > > > > > > > > > relationships between aldosterone and the > > female sex> > > > > hormones> > > > > > > > > > > > > > progesterone and estradiol were not > > investigated.> > > > > > > > > > > > > > Progesterone is postulated to mediate the > > luteal phase> > > > > increase in> > > > > > > > > > > > > > aldosterone levels. Because progesterone > > inhibits> > > > > aldosterone> > > > > > > > > > > > > > binding to the mineralocorticoid receptor > > (1, 3, 16),> > > > > increased> > > > > > > > > > > > > > progesterone production during the luteal > > phase likely> > > > > leads to> > > > > > > > > > > > > > compensatory activation of the RAS and thus > > increased> > > > > aldosterone> > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, it is > > not known> > > > > whether> > > > > > > > > > > > > > additional mechanisms contribute to luteal > > phase> > > > > aldosterone> > > > > > > > > > > > > > increases, independent of the RAS. We > > examined the> > > > > mechanisms by> > > > > > > > > > > > > > which luteal phase aldosterone levels > > increase among> > > > > women in sodium> > > > > > > > > > > > > > balance, because differences in sodium balance> > > > > independently> > > > > > > > > > > > > > influence RAS hormone levels. Furthermore, we> > > > > investigated the role> > > > > > > > > > > > > > of estradiol in the luteal phase aldosterone > > increase,> > > > > which has not> > > > > > > > > > > > > > been previously reported.> > > > > > > > > > > > > >> > > > > > > > > > > > > > The purpose of this study was to compare > > aldosterone> > > > > levels during> > > > > > > > > > > > > > the follicular and luteal phases of the > > menstrual> > > > > cycle among women> > > > > > > > > > > > > > in documented sodium balance, at baseline > > and in> > > > > response to> > > > > > > > > > > > > > angiotensin II (AngII) infusion. We also > > sought to> > > > > investigate the> > > > > > > > > > > > > > relationships between aldosterone and the > > female sex> > > > > hormones> > > > > > > > > > > > > > progesterone and estradiol among women in > > sodium> > > > > balance. Last, we> > > > > > > > > > > > > > aimed to explore additional mechanisms by > > which female> > > > > sex hormones> > > > > > > > > > > > > > may modulate aldosterone production by > > determining> > > > > whether direct> > > > > > > > > > > > > > administration of progesterone or estradiol to> > > > > isolated rat zona> > > > > > > > > > > > > > glomerulosa (ZG) cells influences aldosterone> > > > > production.> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > >> > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > Top> > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > Results> > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > References> > > > > > > > > > > > > >> > > > > > > > > > > > > > Subjects> > > > > > > > > > > > > > Subjects studied as previously described > > (18, 19) by> > > > > the> > > > > > > > > > > > > > international HyperPath (Hypertensive > > Pathotype)> > > > > consortium were> > > > > > > > > > > > > > included in this post hoc analysis. Only > > normotensive,> > > > > premenopausal> > > > > > > > > > > > > > women in sodium balance (as described in a > > subsequent> > > > > paragraph)> > > > > > > > > > > > > > were included. Subjects were excluded if > > they had> > > > > active medical> > > > > > > > > > > > > > problems, were pregnant, or were taking > > exogenous> > > > > estrogens or> > > > > > > > > > > > > > progestins.> > > > > > > > > > > > > >> > > > > > > > > > > > > > Normotension was defined as seated systolic b=> > > > > > >> > > > > >> > > > >> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2010 Report Share Posted September 21, 2010 VA doesn't pay there Dr much. But they say this is because VA dr don't have to have malpratice insurance. So based on this in the end pay comes out the same. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done > > after > > > > you ate a > > > > > > > lot of salt > > > > > > > > > > > > > > > > and was done early in menstrual cycle. You > > > > should read > > > > > > > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE > > > > SEARCH TABLE > > > > > > > OF CONTENTS > > > > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > > > Metabolism , > > > > > > > doi:10.1210/jc. > > > > > > > > > > > > > > > > 2006-1154 > > > > > > > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > Full Text (PDF) > > > > > > > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > > > > > > > Similar articles in this journal > > > > > > > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > > > > > > > Download to citation manager > > > > > > > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > > > > > > > Compound via MeSH > > > > > > > > > > > > > > > > Substance via MeSH > > > > > > > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > > > > > > > ESTRADIOL > > > > > > > > > > > > > > > > PROGESTERONE > > > > > > > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > > > > > > > Female Endocrinology > > > > > > > > > > > > > > > > The Journal of Clinical Endocrinology & > > > > Metabolism > > > > > > > Vol. 91, No. 10 > > > > > > > > > > > > > > > > 3981-3987 > > > > > > > > > > > > > > > > Copyright © 2006 by The Endocrine > > > > > > > Society > > > > > > > > > > > > > > > > Relationship between Aldosterone and > > > > Progesterone in > > > > > > > the Human > > > > > > > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, > > > > S. > > > > > > > , Dina E. > > > > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and > > > > Ellen W. Seely > > > > > > > > > > > > > > > > Division of Endocrinology, Diabetes and > > > > Hypertension > > > > > > > (E.D.S., > > > > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.), > > > > Department of > > > > > > > Medicine, > > > > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard > > > > Medical School, > > > > > > > Boston, > > > > > > > > > > > > > > > > Massachusetts 02115; and Department of > > > > Medicine > > > > > > > (P.N.H.), University > > > > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake > > City, > > > > Utah 84132 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Address all correspondence and requests > > for > > > > reprints > > > > > > > to: Ellen W. > > > > > > > > > > > > > > > > Seely, M.D., Division of Endocrinology, > > > > Diabetes and > > > > > > > Hypertension, > > > > > > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood > > > > Avenue, > > > > > > > Boston, > > > > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase > > during > > > > the luteal > > > > > > > phase of the > > > > > > > > > > > > > > > > menstrual cycle. Prior studies examining > > > > relationships > > > > > > > between > > > > > > > > > > > > > > > > aldosterone and female sex hormones did > > not > > > > control > > > > > > > for sodium > > > > > > > > > > > > > > > > balance, a major determinant of > > aldosterone > > > > > > > production. > > > > > > > > > > > > > > > > Objectives: The objectives of this study > > > > were 1) to > > > > > > > compare > > > > > > > > > > > > > > > > aldosterone levels between menstrual > > phases > > > > among > > > > > > > cycling women in > > > > > > > > > > > > > > > > high- and low-sodium balance; and 2) to > > > > examine the > > > > > > > relationships > > > > > > > > > > > > > > > > between aldosterone and female sex > > hormones > > > > in women > > > > > > > and the effects > > > > > > > > > > > > > > > > of sex hormones on rat zona glomerulosa > > (ZG) > > > > cell > > > > > > > aldosterone > > > > > > > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, > > > > premenopausal > > > > > > > women were > > > > > > > > > > > > > > > > studied in low- and/or high-sodium > > balance. > > > > Urinary > > > > > > > aldosterone, > > > > > > > > > > > > > > > > basal serum aldosterone, plasma renin > > > > activity (PRA), > > > > > > > plasma > > > > > > > > > > > > > > > > angiotensin II (AngII), and serum > > > > aldosterone after > > > > > > > AngII infusion > > > > > > > > > > > > > > > > were measured. Isolated rat ZG cells were > > > > treated with > > > > > > > progesterone, > > > > > > > > > > > > > > > > estradiol, or both, and aldosterone was > > > > measured. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary > > > > aldosterone, > > > > > > > basal serum > > > > > > > > > > > > > > > > aldosterone, and serum aldosterone > > response > > > > to infused > > > > > > > AngII were > > > > > > > > > > > > > > > > significantly greater (P < 0.05) in the > > > > luteal vs. > > > > > > > follicular phase. > > > > > > > > > > > > > > > > PRA, AngII, and potassium did not differ. > > > > Progesterone > > > > > > > directly > > > > > > > > > > > > > > > > correlated with urinary aldosterone, basal > > > > serum > > > > > > > aldosterone, and > > > > > > > > > > > > > > > > serum aldosterone response to infused > > AngII. > > > > Estradiol > > > > > > > did not > > > > > > > > > > > > > > > > significantly correlate with > > aldosterone. In > > > > > > > low-sodium balance, no > > > > > > > > > > > > > > > > significant differences in aldosterone > > > > levels between > > > > > > > phases were > > > > > > > > > > > > > > > > found. In vitro, progesterone increased ZG > > > > cell > > > > > > > aldosterone > > > > > > > > > > > > > > > > production (P < 0.01), whereas estradiol > > had > > > > no > > > > > > > effect. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum > > > > aldosterone > > > > > > > levels are > > > > > > > > > > > > > > > > significantly higher during the luteal > > phase > > > > in high- > > > > > > > but not low- > > > > > > > > > > > > > > > > sodium balance, whereas PRA and AngII do > > not > > > > differ > > > > > > > between phases. > > > > > > > > > > > > > > > > Progesterone may directly contribute to > > > > increased > > > > > > > luteal phase > > > > > > > > > > > > > > > > aldosterone production, independent of the > > > > > > > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to > > > > increase > > > > > > > during the luteal > > > > > > > > > > > > > > > > phase of the human menstrual cycle, a time > > > > > > > characterized by > > > > > > > > > > > > > > > > increased progesterone and estradiol > > > > production. > > > > > > > Although > > > > > > > > > > > > > > > > progesterone is known to have > > > > antimineralocorticoid > > > > > > > effects (1, 2, > > > > > > > > > > > > > > > > 3), it is unclear whether additional > > > > mechanisms > > > > > > > contribute to > > > > > > > > > > > > > > > > increased luteal phase aldosterone > > > > production. Most > > > > > > > prior studies > > > > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10, > > > > 11, 12) or > > > > > > > document (13) > > > > > > > > > > > > > > > > sodium balance, which plays a major role > > in > > > > regulation > > > > > > > of > > > > > > > > > > > > > > > > aldosterone production via the renin- > > > > angiotensin > > > > > > > system (RAS). In > > > > > > > > > > > > > > > > two prior studies that did account for > > > > sodium balance > > > > > > > (14, 15), the > > > > > > > > > > > > > > > > relationships between aldosterone and the > > > > female sex > > > > > > > hormones > > > > > > > > > > > > > > > > progesterone and estradiol were not > > > > investigated. > > > > > > > > > > > > > > > > Progesterone is postulated to mediate the > > > > luteal phase > > > > > > > increase in > > > > > > > > > > > > > > > > aldosterone levels. Because progesterone > > > > inhibits > > > > > > > aldosterone > > > > > > > > > > > > > > > > binding to the mineralocorticoid receptor > > > > (1, 3, 16), > > > > > > > increased > > > > > > > > > > > > > > > > progesterone production during the luteal > > > > phase likely > > > > > > > leads to > > > > > > > > > > > > > > > > compensatory activation of the RAS and > > thus > > > > increased > > > > > > > aldosterone > > > > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, > > it is > > > > not known > > > > > > > whether > > > > > > > > > > > > > > > > additional mechanisms contribute to luteal > > > > phase > > > > > > > aldosterone > > > > > > > > > > > > > > > > increases, independent of the RAS. We > > > > examined the > > > > > > > mechanisms by > > > > > > > > > > > > > > > > which luteal phase aldosterone levels > > > > increase among > > > > > > > women in sodium > > > > > > > > > > > > > > > > balance, because differences in sodium > > balance > > > > > > > independently > > > > > > > > > > > > > > > > influence RAS hormone levels. > > Furthermore, we > > > > > > > investigated the role > > > > > > > > > > > > > > > > of estradiol in the luteal phase > > aldosterone > > > > increase, > > > > > > > which has not > > > > > > > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > The purpose of this study was to compare > > > > aldosterone > > > > > > > levels during > > > > > > > > > > > > > > > > the follicular and luteal phases of the > > > > menstrual > > > > > > > cycle among women > > > > > > > > > > > > > > > > in documented sodium balance, at baseline > > > > and in > > > > > > > response to > > > > > > > > > > > > > > > > angiotensin II (AngII) infusion. We also > > > > sought to > > > > > > > investigate the > > > > > > > > > > > > > > > > relationships between aldosterone and the > > > > female sex > > > > > > > hormones > > > > > > > > > > > > > > > > progesterone and estradiol among women in > > > > sodium > > > > > > > balance. Last, we > > > > > > > > > > > > > > > > aimed to explore additional mechanisms by > > > > which female > > > > > > > sex hormones > > > > > > > > > > > > > > > > may modulate aldosterone production by > > > > determining > > > > > > > whether direct > > > > > > > > > > > > > > > > administration of progesterone or > > estradiol to > > > > > > > isolated rat zona > > > > > > > > > > > > > > > > glomerulosa (ZG) cells influences > > aldosterone > > > > > > > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > > > > > > > Subjects studied as previously described > > > > (18, 19) by > > > > > > > the > > > > > > > > > > > > > > > > international HyperPath (Hypertensive > > > > Pathotype) > > > > > > > consortium were > > > > > > > > > > > > > > > > included in this post hoc analysis. Only > > > > normotensive, > > > > > > > premenopausal > > > > > > > > > > > > > > > > women in sodium balance (as described in a > > > > subsequent > > > > > > > paragraph) > > > > > > > > > > > > > > > > were included. Subjects were excluded if > > > > they had > > > > > > > active medical > > > > > > > > > > > > > > > > problems, were pregnant, or were taking > > > > exogenous > > > > > > > estrogens or > > > > > > > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated > > systolic b= > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2010 Report Share Posted September 21, 2010 Well my malpractice is only ~$4000 a year. Which comes down to about $2 per hour.CE Grim MDOn Sep 21, 2010, at 7:38 PM, Francis Bill SUSPECTED PA wrote:VA doesn't pay there Dr much. But they say this is because VA dr don't have to have malpratice insurance. So based on this in the end pay comes out the same. > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Since you say this aldo/renin was done > > after> > > > you ate a> > > > > > > lot of salt> > > > > > > > > > > > > > > > and was done early in menstrual cycle. You> > > > should read> > > > > > > this study.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE> > > > SEARCH TABLE> > > > > > > OF CONTENTS> > > > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > > > Metabolism ,> > > > > > > doi:10.1210/jc.> > > > > > > > > > > > > > > > 2006-1154> > > > > > > > > > > > > > > > This Article> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > Full Text (PDF)> > > > > > > > > > > > > > > > Submit a related Letter to the Editor> > > > > > > > > > > > > > > > Alert me when this article is cited> > > > > > > > > > > > > > > > Alert me when eLetters are posted> > > > > > > > > > > > > > > > Alert me if a correction is posted> > > > > > > > > > > > > > > > Citation Map> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Services> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Email this article to a friend> > > > > > > > > > > > > > > > Similar articles in this journal> > > > > > > > > > > > > > > > Similar articles in PubMed> > > > > > > > > > > > > > > > Alert me to new issues of the journal> > > > > > > > > > > > > > > > Download to citation manager> > > > > > > > > > > > > > > > Reprints, Permissions and Rights> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Citing Articles> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Citing Articles via HighWire> > > > > > > > > > > > > > > > Citing Articles via Google Scholar> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Google Scholar> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > > > Search for Related Content> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > PubMed> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > PubMed Citation> > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > > > Pubmed/NCBI databases> > > > > > > > > > > > > > > > Compound via MeSH> > > > > > > > > > > > > > > > Substance via MeSH> > > > > > > > > > > > > > > > Hazardous Substances DB> > > > > > > > > > > > > > > > ESTRADIOL> > > > > > > > > > > > > > > > PROGESTERONE> > > > > > > > > > > > > > > > SODIUM> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Related Collections> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Adrenal and Hypertension> > > > > > > > > > > > > > > > Female Endocrinology> > > > > > > > > > > > > > > > The Journal of Clinical Endocrinology & > > > > Metabolism> > > > > > > Vol. 91, No. 10> > > > > > > > > > > > > > > > 3981-3987> > > > > > > > > > > > > > > > Copyright © 2006 by The Endocrine> > > > > > > Society> > > > > > > > > > > > > > > > Relationship between Aldosterone and> > > > Progesterone in> > > > > > > the Human> > > > > > > > > > > > > > > > Menstrual Cycle> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler,> > > > S.> > > > > > > , Dina E.> > > > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins and> > > > Ellen W. Seely> > > > > > > > > > > > > > > > Division of Endocrinology, Diabetes and> > > > Hypertension> > > > > > > (E.D.S.,> > > > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., E.W.S.),> > > > Department of> > > > > > > Medicine,> > > > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard> > > > Medical School,> > > > > > > Boston,> > > > > > > > > > > > > > > > Massachusetts 02115; and Department of> > > > Medicine> > > > > > > (P.N.H.), University> > > > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake > > City,> > > > Utah 84132> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Address all correspondence and requests > > for> > > > reprints> > > > > > > to: Ellen W.> > > > > > > > > > > > > > > > Seely, M.D., Division of Endocrinology,> > > > Diabetes and> > > > > > > Hypertension,> > > > > > > > > > > > > > > > Brigham and Women's Hospital, 221 Longwood> > > > Avenue,> > > > > > > Boston,> > > > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ .> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Context: Aldosterone levels increase > > during> > > > the luteal> > > > > > > phase of the> > > > > > > > > > > > > > > > menstrual cycle. Prior studies examining> > > > relationships> > > > > > > between> > > > > > > > > > > > > > > > aldosterone and female sex hormones did > > not> > > > control> > > > > > > for sodium> > > > > > > > > > > > > > > > balance, a major determinant of > > aldosterone> > > > > > > production.> > > > > > > > > > > > > > > > Objectives: The objectives of this study> > > > were 1) to> > > > > > > compare> > > > > > > > > > > > > > > > aldosterone levels between menstrual > > phases> > > > among> > > > > > > cycling women in> > > > > > > > > > > > > > > > high- and low-sodium balance; and 2) to> > > > examine the> > > > > > > relationships> > > > > > > > > > > > > > > > between aldosterone and female sex > > hormones> > > > in women> > > > > > > and the effects> > > > > > > > > > > > > > > > of sex hormones on rat zona glomerulosa > > (ZG)> > > > cell> > > > > > > aldosterone> > > > > > > > > > > > > > > > production in vitro.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive,> > > > premenopausal> > > > > > > women were> > > > > > > > > > > > > > > > studied in low- and/or high-sodium > > balance.> > > > Urinary> > > > > > > aldosterone,> > > > > > > > > > > > > > > > basal serum aldosterone, plasma renin> > > > activity (PRA),> > > > > > > plasma> > > > > > > > > > > > > > > > angiotensin II (AngII), and serum> > > > aldosterone after> > > > > > > AngII infusion> > > > > > > > > > > > > > > > were measured. Isolated rat ZG cells were> > > > treated with> > > > > > > progesterone,> > > > > > > > > > > > > > > > estradiol, or both, and aldosterone was> > > > measured.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Results: In high-sodium balance, urinary> > > > aldosterone,> > > > > > > basal serum> > > > > > > > > > > > > > > > aldosterone, and serum aldosterone > > response> > > > to infused> > > > > > > AngII were> > > > > > > > > > > > > > > > significantly greater (P < 0.05) in the> > > > luteal vs.> > > > > > > follicular phase.> > > > > > > > > > > > > > > > PRA, AngII, and potassium did not differ.> > > > Progesterone> > > > > > > directly> > > > > > > > > > > > > > > > correlated with urinary aldosterone, basal> > > > serum> > > > > > > aldosterone, and> > > > > > > > > > > > > > > > serum aldosterone response to infused > > AngII.> > > > Estradiol> > > > > > > did not> > > > > > > > > > > > > > > > significantly correlate with > > aldosterone. In> > > > > > > low-sodium balance, no> > > > > > > > > > > > > > > > significant differences in aldosterone> > > > levels between> > > > > > > phases were> > > > > > > > > > > > > > > > found. In vitro, progesterone increased ZG> > > > cell> > > > > > > aldosterone> > > > > > > > > > > > > > > > production (P < 0.01), whereas estradiol > > had> > > > no> > > > > > > effect.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Conclusions: In women, urinary and serum> > > > aldosterone> > > > > > > levels are> > > > > > > > > > > > > > > > significantly higher during the luteal > > phase> > > > in high-> > > > > > > but not low-> > > > > > > > > > > > > > > > sodium balance, whereas PRA and AngII do > > not> > > > differ> > > > > > > between phases.> > > > > > > > > > > > > > > > Progesterone may directly contribute to> > > > increased> > > > > > > luteal phase> > > > > > > > > > > > > > > > aldosterone production, independent of the> > > > > > > renin-angiotensin system.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been reported to> > > > increase> > > > > > > during the luteal> > > > > > > > > > > > > > > > phase of the human menstrual cycle, a time> > > > > > > characterized by> > > > > > > > > > > > > > > > increased progesterone and estradiol> > > > production.> > > > > > > Although> > > > > > > > > > > > > > > > progesterone is known to have> > > > antimineralocorticoid> > > > > > > effects (1, 2,> > > > > > > > > > > > > > > > 3), it is unclear whether additional> > > > mechanisms> > > > > > > contribute to> > > > > > > > > > > > > > > > increased luteal phase aldosterone> > > > production. Most> > > > > > > prior studies> > > > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, 9, 10,> > > > 11, 12) or> > > > > > > document (13)> > > > > > > > > > > > > > > > sodium balance, which plays a major role > > in> > > > regulation> > > > > > > of> > > > > > > > > > > > > > > > aldosterone production via the renin-> > > > angiotensin> > > > > > > system (RAS). In> > > > > > > > > > > > > > > > two prior studies that did account for> > > > sodium balance> > > > > > > (14, 15), the> > > > > > > > > > > > > > > > relationships between aldosterone and the> > > > female sex> > > > > > > hormones> > > > > > > > > > > > > > > > progesterone and estradiol were not> > > > investigated.> > > > > > > > > > > > > > > > Progesterone is postulated to mediate the> > > > luteal phase> > > > > > > increase in> > > > > > > > > > > > > > > > aldosterone levels. Because progesterone> > > > inhibits> > > > > > > aldosterone> > > > > > > > > > > > > > > > binding to the mineralocorticoid receptor> > > > (1, 3, 16),> > > > > > > increased> > > > > > > > > > > > > > > > progesterone production during the luteal> > > > phase likely> > > > > > > leads to> > > > > > > > > > > > > > > > compensatory activation of the RAS and > > thus> > > > increased> > > > > > > aldosterone> > > > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, > > it is> > > > not known> > > > > > > whether> > > > > > > > > > > > > > > > additional mechanisms contribute to luteal> > > > phase> > > > > > > aldosterone> > > > > > > > > > > > > > > > increases, independent of the RAS. We> > > > examined the> > > > > > > mechanisms by> > > > > > > > > > > > > > > > which luteal phase aldosterone levels> > > > increase among> > > > > > > women in sodium> > > > > > > > > > > > > > > > balance, because differences in sodium > > balance> > > > > > > independently> > > > > > > > > > > > > > > > influence RAS hormone levels. > > Furthermore, we> > > > > > > investigated the role> > > > > > > > > > > > > > > > of estradiol in the luteal phase > > aldosterone> > > > increase,> > > > > > > which has not> > > > > > > > > > > > > > > > been previously reported.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > The purpose of this study was to compare> > > > aldosterone> > > > > > > levels during> > > > > > > > > > > > > > > > the follicular and luteal phases of the> > > > menstrual> > > > > > > cycle among women> > > > > > > > > > > > > > > > in documented sodium balance, at baseline> > > > and in> > > > > > > response to> > > > > > > > > > > > > > > > angiotensin II (AngII) infusion. We also> > > > sought to> > > > > > > investigate the> > > > > > > > > > > > > > > > relationships between aldosterone and the> > > > female sex> > > > > > > hormones> > > > > > > > > > > > > > > > progesterone and estradiol among women in> > > > sodium> > > > > > > balance. Last, we> > > > > > > > > > > > > > > > aimed to explore additional mechanisms by> > > > which female> > > > > > > sex hormones> > > > > > > > > > > > > > > > may modulate aldosterone production by> > > > determining> > > > > > > whether direct> > > > > > > > > > > > > > > > administration of progesterone or > > estradiol to> > > > > > > isolated rat zona> > > > > > > > > > > > > > > > glomerulosa (ZG) cells influences > > aldosterone> > > > > > > production.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Subjects> > > > > > > > > > > > > > > > Subjects studied as previously described> > > > (18, 19) by> > > > > > > the> > > > > > > > > > > > > > > > international HyperPath (Hypertensive> > > > Pathotype)> > > > > > > consortium were> > > > > > > > > > > > > > > > included in this post hoc analysis. Only> > > > normotensive,> > > > > > > premenopausal> > > > > > > > > > > > > > > > women in sodium balance (as described in a> > > > subsequent> > > > > > > paragraph)> > > > > > > > > > > > > > > > were included. Subjects were excluded if> > > > they had> > > > > > > active medical> > > > > > > > > > > > > > > > problems, were pregnant, or were taking> > > > exogenous> > > > > > > estrogens or> > > > > > > > > > > > > > > > progestins.> > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > Normotension was defined as seated > > systolic b=> > > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2010 Report Share Posted September 22, 2010 Question is what should Dr get paid? Some a lot more then others. Many of us pay more to have our car fixed then what we our Dr. This link is a listing of the Dr that the VA needs. looks like the starting pay is about $95000 a year. http://www.jobsearch.vacareers.va.gov/Search.aspx?jbf522=0602 & salmin= & salmax= & jb\ f574=VA* & vw=b & brd=3876 & ss=0 & customapplicant=15514%2C15515%2C15523%2C15510%2C1551\ 2%2C15516%2C45575%2C15669 & submit1.x=0 & submit1.y=0 & pg=1 & re=0 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done > > > > after > > > > > > you ate a > > > > > > > > > lot of salt > > > > > > > > > > > > > > > > > > and was done early in menstrual > > cycle. You > > > > > > should read > > > > > > > > > this study. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS > > ARCHIVE > > > > > > SEARCH TABLE > > > > > > > > > OF CONTENTS > > > > > > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > > > > > Metabolism , > > > > > > > > > doi:10.1210/jc. > > > > > > > > > > > > > > > > > > 2006-1154 > > > > > > > > > > > > > > > > > > This Article > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > > > Full Text (PDF) > > > > > > > > > > > > > > > > > > Submit a related Letter to the Editor > > > > > > > > > > > > > > > > > > Alert me when this article is cited > > > > > > > > > > > > > > > > > > Alert me when eLetters are posted > > > > > > > > > > > > > > > > > > Alert me if a correction is posted > > > > > > > > > > > > > > > > > > Citation Map > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Services > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Email this article to a friend > > > > > > > > > > > > > > > > > > Similar articles in this journal > > > > > > > > > > > > > > > > > > Similar articles in PubMed > > > > > > > > > > > > > > > > > > Alert me to new issues of the journal > > > > > > > > > > > > > > > > > > Download to citation manager > > > > > > > > > > > > > > > > > > Reprints, Permissions and Rights > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Citing Articles via HighWire > > > > > > > > > > > > > > > > > > Citing Articles via Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Google Scholar > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > > > > > Search for Related Content > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > PubMed Citation > > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D. > > > > > > > > > > > > > > > > > > Articles by Seely, E. W. > > > > > > > > > > > > > > > > > > Pubmed/NCBI databases > > > > > > > > > > > > > > > > > > Compound via MeSH > > > > > > > > > > > > > > > > > > Substance via MeSH > > > > > > > > > > > > > > > > > > Hazardous Substances DB > > > > > > > > > > > > > > > > > > ESTRADIOL > > > > > > > > > > > > > > > > > > PROGESTERONE > > > > > > > > > > > > > > > > > > SODIUM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Related Collections > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Adrenal and Hypertension > > > > > > > > > > > > > > > > > > Female Endocrinology > > > > > > > > > > > > > > > > > > The Journal of Clinical > > Endocrinology & > > > > > > Metabolism > > > > > > > > > Vol. 91, No. 10 > > > > > > > > > > > > > > > > > > 3981-3987 > > > > > > > > > > > > > > > > > > Copyright © 2006 by The > > Endocrine > > > > > > > > > Society > > > > > > > > > > > > > > > > > > Relationship between Aldosterone and > > > > > > Progesterone in > > > > > > > > > the Human > > > > > > > > > > > > > > > > > > Menstrual Cycle > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler, > > > > > > S. > > > > > > > > > , Dina E. > > > > > > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins > > and > > > > > > Ellen W. Seely > > > > > > > > > > > > > > > > > > Division of Endocrinology, Diabetes > > and > > > > > > Hypertension > > > > > > > > > (E.D.S., > > > > > > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., > > E.W.S.), > > > > > > Department of > > > > > > > > > Medicine, > > > > > > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard > > > > > > Medical School, > > > > > > > > > Boston, > > > > > > > > > > > > > > > > > > Massachusetts 02115; and Department of > > > > > > Medicine > > > > > > > > > (P.N.H.), University > > > > > > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake > > > > City, > > > > > > Utah 84132 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Address all correspondence and > > requests > > > > for > > > > > > reprints > > > > > > > > > to: Ellen W. > > > > > > > > > > > > > > > > > > Seely, M.D., Division of > > Endocrinology, > > > > > > Diabetes and > > > > > > > > > Hypertension, > > > > > > > > > > > > > > > > > > Brigham and Women's Hospital, 221 > > Longwood > > > > > > Avenue, > > > > > > > > > Boston, > > > > > > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase > > > > during > > > > > > the luteal > > > > > > > > > phase of the > > > > > > > > > > > > > > > > > > menstrual cycle. Prior studies > > examining > > > > > > relationships > > > > > > > > > between > > > > > > > > > > > > > > > > > > aldosterone and female sex hormones > > did > > > > not > > > > > > control > > > > > > > > > for sodium > > > > > > > > > > > > > > > > > > balance, a major determinant of > > > > aldosterone > > > > > > > > > production. > > > > > > > > > > > > > > > > > > Objectives: The objectives of this > > study > > > > > > were 1) to > > > > > > > > > compare > > > > > > > > > > > > > > > > > > aldosterone levels between menstrual > > > > phases > > > > > > among > > > > > > > > > cycling women in > > > > > > > > > > > > > > > > > > high- and low-sodium balance; and 2) > > to > > > > > > examine the > > > > > > > > > relationships > > > > > > > > > > > > > > > > > > between aldosterone and female sex > > > > hormones > > > > > > in women > > > > > > > > > and the effects > > > > > > > > > > > > > > > > > > of sex hormones on rat zona > > glomerulosa > > > > (ZG) > > > > > > cell > > > > > > > > > aldosterone > > > > > > > > > > > > > > > > > > production in vitro. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive, > > > > > > premenopausal > > > > > > > > > women were > > > > > > > > > > > > > > > > > > studied in low- and/or high-sodium > > > > balance. > > > > > > Urinary > > > > > > > > > aldosterone, > > > > > > > > > > > > > > > > > > basal serum aldosterone, plasma renin > > > > > > activity (PRA), > > > > > > > > > plasma > > > > > > > > > > > > > > > > > > angiotensin II (AngII), and serum > > > > > > aldosterone after > > > > > > > > > AngII infusion > > > > > > > > > > > > > > > > > > were measured. Isolated rat ZG cells > > were > > > > > > treated with > > > > > > > > > progesterone, > > > > > > > > > > > > > > > > > > estradiol, or both, and aldosterone > > was > > > > > > measured. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Results: In high-sodium balance, > > urinary > > > > > > aldosterone, > > > > > > > > > basal serum > > > > > > > > > > > > > > > > > > aldosterone, and serum aldosterone > > > > response > > > > > > to infused > > > > > > > > > AngII were > > > > > > > > > > > > > > > > > > significantly greater (P < 0.05) in > > the > > > > > > luteal vs. > > > > > > > > > follicular phase. > > > > > > > > > > > > > > > > > > PRA, AngII, and potassium did not > > differ. > > > > > > Progesterone > > > > > > > > > directly > > > > > > > > > > > > > > > > > > correlated with urinary aldosterone, > > basal > > > > > > serum > > > > > > > > > aldosterone, and > > > > > > > > > > > > > > > > > > serum aldosterone response to infused > > > > AngII. > > > > > > Estradiol > > > > > > > > > did not > > > > > > > > > > > > > > > > > > significantly correlate with > > > > aldosterone. In > > > > > > > > > low-sodium balance, no > > > > > > > > > > > > > > > > > > significant differences in aldosterone > > > > > > levels between > > > > > > > > > phases were > > > > > > > > > > > > > > > > > > found. In vitro, progesterone > > increased ZG > > > > > > cell > > > > > > > > > aldosterone > > > > > > > > > > > > > > > > > > production (P < 0.01), whereas > > estradiol > > > > had > > > > > > no > > > > > > > > > effect. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and > > serum > > > > > > aldosterone > > > > > > > > > levels are > > > > > > > > > > > > > > > > > > significantly higher during the luteal > > > > phase > > > > > > in high- > > > > > > > > > but not low- > > > > > > > > > > > > > > > > > > sodium balance, whereas PRA and > > AngII do > > > > not > > > > > > differ > > > > > > > > > between phases. > > > > > > > > > > > > > > > > > > Progesterone may directly contribute > > to > > > > > > increased > > > > > > > > > luteal phase > > > > > > > > > > > > > > > > > > aldosterone production, independent > > of the > > > > > > > > > renin-angiotensin system. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been > > reported to > > > > > > increase > > > > > > > > > during the luteal > > > > > > > > > > > > > > > > > > phase of the human menstrual cycle, > > a time > > > > > > > > > characterized by > > > > > > > > > > > > > > > > > > increased progesterone and estradiol > > > > > > production. > > > > > > > > > Although > > > > > > > > > > > > > > > > > > progesterone is known to have > > > > > > antimineralocorticoid > > > > > > > > > effects (1, 2, > > > > > > > > > > > > > > > > > > 3), it is unclear whether additional > > > > > > mechanisms > > > > > > > > > contribute to > > > > > > > > > > > > > > > > > > increased luteal phase aldosterone > > > > > > production. Most > > > > > > > > > prior studies > > > > > > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, > > 9, 10, > > > > > > 11, 12) or > > > > > > > > > document (13) > > > > > > > > > > > > > > > > > > sodium balance, which plays a major > > role > > > > in > > > > > > regulation > > > > > > > > > of > > > > > > > > > > > > > > > > > > aldosterone production via the renin- > > > > > > angiotensin > > > > > > > > > system (RAS). In > > > > > > > > > > > > > > > > > > two prior studies that did account for > > > > > > sodium balance > > > > > > > > > (14, 15), the > > > > > > > > > > > > > > > > > > relationships between aldosterone > > and the > > > > > > female sex > > > > > > > > > hormones > > > > > > > > > > > > > > > > > > progesterone and estradiol were not > > > > > > investigated. > > > > > > > > > > > > > > > > > > Progesterone is postulated to > > mediate the > > > > > > luteal phase > > > > > > > > > increase in > > > > > > > > > > > > > > > > > > aldosterone levels. Because > > progesterone > > > > > > inhibits > > > > > > > > > aldosterone > > > > > > > > > > > > > > > > > > binding to the mineralocorticoid > > receptor > > > > > > (1, 3, 16), > > > > > > > > > increased > > > > > > > > > > > > > > > > > > progesterone production during the > > luteal > > > > > > phase likely > > > > > > > > > leads to > > > > > > > > > > > > > > > > > > compensatory activation of the RAS and > > > > thus > > > > > > increased > > > > > > > > > aldosterone > > > > > > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However, > > > > it is > > > > > > not known > > > > > > > > > whether > > > > > > > > > > > > > > > > > > additional mechanisms contribute to > > luteal > > > > > > phase > > > > > > > > > aldosterone > > > > > > > > > > > > > > > > > > increases, independent of the RAS. We > > > > > > examined the > > > > > > > > > mechanisms by > > > > > > > > > > > > > > > > > > which luteal phase aldosterone levels > > > > > > increase among > > > > > > > > > women in sodium > > > > > > > > > > > > > > > > > > balance, because differences in sodium > > > > balance > > > > > > > > > independently > > > > > > > > > > > > > > > > > > influence RAS hormone levels. > > > > Furthermore, we > > > > > > > > > investigated the role > > > > > > > > > > > > > > > > > > of estradiol in the luteal phase > > > > aldosterone > > > > > > increase, > > > > > > > > > which has not > > > > > > > > > > > > > > > > > > been previously reported. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > The purpose of this study was to > > compare > > > > > > aldosterone > > > > > > > > > levels during > > > > > > > > > > > > > > > > > > the follicular and luteal phases of > > the > > > > > > menstrual > > > > > > > > > cycle among women > > > > > > > > > > > > > > > > > > in documented sodium balance, at > > baseline > > > > > > and in > > > > > > > > > response to > > > > > > > > > > > > > > > > > > angiotensin II (AngII) infusion. We > > also > > > > > > sought to > > > > > > > > > investigate the > > > > > > > > > > > > > > > > > > relationships between aldosterone > > and the > > > > > > female sex > > > > > > > > > hormones > > > > > > > > > > > > > > > > > > progesterone and estradiol among > > women in > > > > > > sodium > > > > > > > > > balance. Last, we > > > > > > > > > > > > > > > > > > aimed to explore additional > > mechanisms by > > > > > > which female > > > > > > > > > sex hormones > > > > > > > > > > > > > > > > > > may modulate aldosterone production by > > > > > > determining > > > > > > > > > whether direct > > > > > > > > > > > > > > > > > > administration of progesterone or > > > > estradiol to > > > > > > > > > isolated rat zona > > > > > > > > > > > > > > > > > > glomerulosa (ZG) cells influences > > > > aldosterone > > > > > > > > > production. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > > > Top > > > > > > > > > > > > > > > > > > Abstract > > > > > > > > > > > > > > > > > > Introduction > > > > > > > > > > > > > > > > > > Subjects and Methods > > > > > > > > > > > > > > > > > > Results > > > > > > > > > > > > > > > > > > Discussion > > > > > > > > > > > > > > > > > > References > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Subjects > > > > > > > > > > > > > > > > > > Subjects studied as previously > > described > > > > > > (18, 19) by > > > > > > > > > the > > > > > > > > > > > > > > > > > > international HyperPath (Hypertensive > > > > > > Pathotype) > > > > > > > > > consortium were > > > > > > > > > > > > > > > > > > included in this post hoc analysis. > > Only > > > > > > normotensive, > > > > > > > > > premenopausal > > > > > > > > > > > > > > > > > > women in sodium balance (as > > described in a > > > > > > subsequent > > > > > > > > > paragraph) > > > > > > > > > > > > > > > > > > were included. Subjects were > > excluded if > > > > > > they had > > > > > > > > > active medical > > > > > > > > > > > > > > > > > > problems, were pregnant, or were > > taking > > > > > > exogenous > > > > > > > > > estrogens or > > > > > > > > > > > > > > > > > > progestins. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Normotension was defined as seated > > > > systolic b= > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2010 Report Share Posted September 22, 2010 One of the reasons to do a locum is to get associated with the VA so I can get a part time gig close to my retirement place in S Lake Tahoe.CE Grim MDOn Sep 22, 2010, at 7:23 AM, Francis Bill SUSPECTED PA wrote:Question is what should Dr get paid? Some a lot more then others. Many of us pay more to have our car fixed then what we our Dr. This link is a listing of the Dr that the VA needs. looks like the starting pay is about $95000 a year.http://www.jobsearch.vacareers.va.gov/Search.aspx?jbf522=0602 & salmin= & salmax= & jbf574=VA* & vw=b & brd=3876 & ss=0 & customapplicant=15514%2C15515%2C15523%2C15510%2C15512%2C15516%2C45575%2C15669 & submit1.x=0 & submit1.y=0 & pg=1 & re=0--- In hyperaldosteronism , Clarence Grim wrote:>> Well my malpractice is only ~$4000 a year. Which comes down to about > $2 per hour.> > CE Grim MD> On Sep 21, 2010, at 7:38 PM, Francis Bill SUSPECTED PA wrote:> > > VA doesn't pay there Dr much. But they say this is because VA dr > > don't have to have malpratice insurance. So based on this in the end > > pay comes out the same.> >> > > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Since you say this aldo/renin was done> > > > after> > > > > > you ate a> > > > > > > > > lot of salt> > > > > > > > > > > > > > > > > > and was done early in menstrual > > cycle. You> > > > > > should read> > > > > > > > > this study.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > HOME HELP FEEDBACK SUBSCRIPTIONS > > ARCHIVE> > > > > > SEARCH TABLE> > > > > > > > > OF CONTENTS> > > > > > > > > > > > > > > > > > Journal of Clinical Endocrinology & > > > > > > Metabolism ,> > > > > > > > > doi:10.1210/jc.> > > > > > > > > > > > > > > > > > 2006-1154> > > > > > > > > > > > > > > > > > This Article> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > > > Full Text (PDF)> > > > > > > > > > > > > > > > > > Submit a related Letter to the Editor> > > > > > > > > > > > > > > > > > Alert me when this article is cited> > > > > > > > > > > > > > > > > > Alert me when eLetters are posted> > > > > > > > > > > > > > > > > > Alert me if a correction is posted> > > > > > > > > > > > > > > > > > Citation Map> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Services> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Email this article to a friend> > > > > > > > > > > > > > > > > > Similar articles in this journal> > > > > > > > > > > > > > > > > > Similar articles in PubMed> > > > > > > > > > > > > > > > > > Alert me to new issues of the journal> > > > > > > > > > > > > > > > > > Download to citation manager> > > > > > > > > > > > > > > > > > Reprints, Permissions and Rights> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Citing Articles> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Citing Articles via HighWire> > > > > > > > > > > > > > > > > > Citing Articles via Google Scholar> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Google Scholar> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > > > > > Search for Related Content> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > PubMed> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > PubMed Citation> > > > > > > > > > > > > > > > > > Articles by Szmuilowicz, E. D.> > > > > > > > > > > > > > > > > > Articles by Seely, E. W.> > > > > > > > > > > > > > > > > > Pubmed/NCBI databases> > > > > > > > > > > > > > > > > > Compound via MeSH> > > > > > > > > > > > > > > > > > Substance via MeSH> > > > > > > > > > > > > > > > > > Hazardous Substances DB> > > > > > > > > > > > > > > > > > ESTRADIOL> > > > > > > > > > > > > > > > > > PROGESTERONE> > > > > > > > > > > > > > > > > > SODIUM> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Related Collections> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Adrenal and Hypertension> > > > > > > > > > > > > > > > > > Female Endocrinology> > > > > > > > > > > > > > > > > > The Journal of Clinical > > Endocrinology & > > > > > > Metabolism> > > > > > > > > Vol. 91, No. 10> > > > > > > > > > > > > > > > > > 3981-3987> > > > > > > > > > > > > > > > > > Copyright © 2006 by The > > Endocrine> > > > > > > > > Society> > > > > > > > > > > > > > > > > > Relationship between Aldosterone and> > > > > > Progesterone in> > > > > > > > > the Human> > > > > > > > > > > > > > > > > > Menstrual Cycle> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > D. Szmuilowicz, Gail K. Adler,> > > > > > S.> > > > > > > > > , Dina E.> > > > > > > > > > > > > > > > > > Green, Tham M. Yao, N. Hopkins > > and> > > > > > Ellen W. Seely> > > > > > > > > > > > > > > > > > Division of Endocrinology, Diabetes > > and> > > > > > Hypertension> > > > > > > > > (E.D.S.,> > > > > > > > > > > > > > > > > > G.K.A., J.S.W., D.E.G., T.M.Y., > > E.W.S.),> > > > > > Department of> > > > > > > > > Medicine,> > > > > > > > > > > > > > > > > > Brigham and Women's Hospital, Harvard> > > > > > Medical School,> > > > > > > > > Boston,> > > > > > > > > > > > > > > > > > Massachusetts 02115; and Department of> > > > > > Medicine> > > > > > > > > (P.N.H.), University> > > > > > > > > > > > > > > > > > of Utah School of Medicine, Salt Lake> > > > City,> > > > > > Utah 84132> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Address all correspondence and > > requests> > > > for> > > > > > reprints> > > > > > > > > to: Ellen W.> > > > > > > > > > > > > > > > > > Seely, M.D., Division of > > Endocrinology,> > > > > > Diabetes and> > > > > > > > > Hypertension,> > > > > > > > > > > > > > > > > > Brigham and Women's Hospital, 221 > > Longwood> > > > > > Avenue,> > > > > > > > > Boston,> > > > > > > > > > > > > > > > > > Massachusetts 02115. E-mail: eseely@ .> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Context: Aldosterone levels increase> > > > during> > > > > > the luteal> > > > > > > > > phase of the> > > > > > > > > > > > > > > > > > menstrual cycle. Prior studies > > examining> > > > > > relationships> > > > > > > > > between> > > > > > > > > > > > > > > > > > aldosterone and female sex hormones > > did> > > > not> > > > > > control> > > > > > > > > for sodium> > > > > > > > > > > > > > > > > > balance, a major determinant of> > > > aldosterone> > > > > > > > > production.> > > > > > > > > > > > > > > > > > Objectives: The objectives of this > > study> > > > > > were 1) to> > > > > > > > > compare> > > > > > > > > > > > > > > > > > aldosterone levels between menstrual> > > > phases> > > > > > among> > > > > > > > > cycling women in> > > > > > > > > > > > > > > > > > high- and low-sodium balance; and 2) > > to> > > > > > examine the> > > > > > > > > relationships> > > > > > > > > > > > > > > > > > between aldosterone and female sex> > > > hormones> > > > > > in women> > > > > > > > > and the effects> > > > > > > > > > > > > > > > > > of sex hormones on rat zona > > glomerulosa> > > > (ZG)> > > > > > cell> > > > > > > > > aldosterone> > > > > > > > > > > > > > > > > > production in vitro.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Subjects/Interventions: Normotensive,> > > > > > premenopausal> > > > > > > > > women were> > > > > > > > > > > > > > > > > > studied in low- and/or high-sodium> > > > balance.> > > > > > Urinary> > > > > > > > > aldosterone,> > > > > > > > > > > > > > > > > > basal serum aldosterone, plasma renin> > > > > > activity (PRA),> > > > > > > > > plasma> > > > > > > > > > > > > > > > > > angiotensin II (AngII), and serum> > > > > > aldosterone after> > > > > > > > > AngII infusion> > > > > > > > > > > > > > > > > > were measured. Isolated rat ZG cells > > were> > > > > > treated with> > > > > > > > > progesterone,> > > > > > > > > > > > > > > > > > estradiol, or both, and aldosterone > > was> > > > > > measured.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Results: In high-sodium balance, > > urinary> > > > > > aldosterone,> > > > > > > > > basal serum> > > > > > > > > > > > > > > > > > aldosterone, and serum aldosterone> > > > response> > > > > > to infused> > > > > > > > > AngII were> > > > > > > > > > > > > > > > > > significantly greater (P < 0.05) in > > the> > > > > > luteal vs.> > > > > > > > > follicular phase.> > > > > > > > > > > > > > > > > > PRA, AngII, and potassium did not > > differ.> > > > > > Progesterone> > > > > > > > > directly> > > > > > > > > > > > > > > > > > correlated with urinary aldosterone, > > basal> > > > > > serum> > > > > > > > > aldosterone, and> > > > > > > > > > > > > > > > > > serum aldosterone response to infused> > > > AngII.> > > > > > Estradiol> > > > > > > > > did not> > > > > > > > > > > > > > > > > > significantly correlate with> > > > aldosterone. In> > > > > > > > > low-sodium balance, no> > > > > > > > > > > > > > > > > > significant differences in aldosterone> > > > > > levels between> > > > > > > > > phases were> > > > > > > > > > > > > > > > > > found. In vitro, progesterone > > increased ZG> > > > > > cell> > > > > > > > > aldosterone> > > > > > > > > > > > > > > > > > production (P < 0.01), whereas > > estradiol> > > > had> > > > > > no> > > > > > > > > effect.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Conclusions: In women, urinary and > > serum> > > > > > aldosterone> > > > > > > > > levels are> > > > > > > > > > > > > > > > > > significantly higher during the luteal> > > > phase> > > > > > in high-> > > > > > > > > but not low-> > > > > > > > > > > > > > > > > > sodium balance, whereas PRA and > > AngII do> > > > not> > > > > > differ> > > > > > > > > between phases.> > > > > > > > > > > > > > > > > > Progesterone may directly contribute > > to> > > > > > increased> > > > > > > > > luteal phase> > > > > > > > > > > > > > > > > > aldosterone production, independent > > of the> > > > > > > > > renin-angiotensin system.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > ALDOSTERONE LEVELS HAVE been > > reported to> > > > > > increase> > > > > > > > > during the luteal> > > > > > > > > > > > > > > > > > phase of the human menstrual cycle, > > a time> > > > > > > > > characterized by> > > > > > > > > > > > > > > > > > increased progesterone and estradiol> > > > > > production.> > > > > > > > > Although> > > > > > > > > > > > > > > > > > progesterone is known to have> > > > > > antimineralocorticoid> > > > > > > > > effects (1, 2,> > > > > > > > > > > > > > > > > > 3), it is unclear whether additional> > > > > > mechanisms> > > > > > > > > contribute to> > > > > > > > > > > > > > > > > > increased luteal phase aldosterone> > > > > > production. Most> > > > > > > > > prior studies> > > > > > > > > > > > > > > > > > did not control for (4, 5, 6, 7, 8, > > 9, 10,> > > > > > 11, 12) or> > > > > > > > > document (13)> > > > > > > > > > > > > > > > > > sodium balance, which plays a major > > role> > > > in> > > > > > regulation> > > > > > > > > of> > > > > > > > > > > > > > > > > > aldosterone production via the renin-> > > > > > angiotensin> > > > > > > > > system (RAS). In> > > > > > > > > > > > > > > > > > two prior studies that did account for> > > > > > sodium balance> > > > > > > > > (14, 15), the> > > > > > > > > > > > > > > > > > relationships between aldosterone > > and the> > > > > > female sex> > > > > > > > > hormones> > > > > > > > > > > > > > > > > > progesterone and estradiol were not> > > > > > investigated.> > > > > > > > > > > > > > > > > > Progesterone is postulated to > > mediate the> > > > > > luteal phase> > > > > > > > > increase in> > > > > > > > > > > > > > > > > > aldosterone levels. Because > > progesterone> > > > > > inhibits> > > > > > > > > aldosterone> > > > > > > > > > > > > > > > > > binding to the mineralocorticoid > > receptor> > > > > > (1, 3, 16),> > > > > > > > > increased> > > > > > > > > > > > > > > > > > progesterone production during the > > luteal> > > > > > phase likely> > > > > > > > > leads to> > > > > > > > > > > > > > > > > > compensatory activation of the RAS and> > > > thus> > > > > > increased> > > > > > > > > aldosterone> > > > > > > > > > > > > > > > > > production (6, 8, 9, 12, 17). However,> > > > it is> > > > > > not known> > > > > > > > > whether> > > > > > > > > > > > > > > > > > additional mechanisms contribute to > > luteal> > > > > > phase> > > > > > > > > aldosterone> > > > > > > > > > > > > > > > > > increases, independent of the RAS. We> > > > > > examined the> > > > > > > > > mechanisms by> > > > > > > > > > > > > > > > > > which luteal phase aldosterone levels> > > > > > increase among> > > > > > > > > women in sodium> > > > > > > > > > > > > > > > > > balance, because differences in sodium> > > > balance> > > > > > > > > independently> > > > > > > > > > > > > > > > > > influence RAS hormone levels.> > > > Furthermore, we> > > > > > > > > investigated the role> > > > > > > > > > > > > > > > > > of estradiol in the luteal phase> > > > aldosterone> > > > > > increase,> > > > > > > > > which has not> > > > > > > > > > > > > > > > > > been previously reported.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > The purpose of this study was to > > compare> > > > > > aldosterone> > > > > > > > > levels during> > > > > > > > > > > > > > > > > > the follicular and luteal phases of > > the> > > > > > menstrual> > > > > > > > > cycle among women> > > > > > > > > > > > > > > > > > in documented sodium balance, at > > baseline> > > > > > and in> > > > > > > > > response to> > > > > > > > > > > > > > > > > > angiotensin II (AngII) infusion. We > > also> > > > > > sought to> > > > > > > > > investigate the> > > > > > > > > > > > > > > > > > relationships between aldosterone > > and the> > > > > > female sex> > > > > > > > > hormones> > > > > > > > > > > > > > > > > > progesterone and estradiol among > > women in> > > > > > sodium> > > > > > > > > balance. Last, we> > > > > > > > > > > > > > > > > > aimed to explore additional > > mechanisms by> > > > > > which female> > > > > > > > > sex hormones> > > > > > > > > > > > > > > > > > may modulate aldosterone production by> > > > > > determining> > > > > > > > > whether direct> > > > > > > > > > > > > > > > > > administration of progesterone or> > > > estradiol to> > > > > > > > > isolated rat zona> > > > > > > > > > > > > > > > > > glomerulosa (ZG) cells influences> > > > aldosterone> > > > > > > > > production.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > > > Top> > > > > > > > > > > > > > > > > > Abstract> > > > > > > > > > > > > > > > > > Introduction> > > > > > > > > > > > > > > > > > Subjects and Methods> > > > > > > > > > > > > > > > > > Results> > > > > > > > > > > > > > > > > > Discussion> > > > > > > > > > > > > > > > > > References> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Subjects> > > > > > > > > > > > > > > > > > Subjects studied as previously > > described> > > > > > (18, 19) by> > > > > > > > > the> > > > > > > > > > > > > > > > > > international HyperPath (Hypertensive> > > > > > Pathotype)> > > > > > > > > consortium were> > > > > > > > > > > > > > > > > > included in this post hoc analysis. > > Only> > > > > > normotensive,> > > > > > > > > premenopausal> > > > > > > > > > > > > > > > > > women in sodium balance (as > > described in a> > > > > > subsequent> > > > > > > > > paragraph)> > > > > > > > > > > > > > > > > > were included. Subjects were > > excluded if> > > > > > they had> > > > > > > > > active medical> > > > > > > > > > > > > > > > > > problems, were pregnant, or were > > taking> > > > > > exogenous> > > > > > > > > estrogens or> > > > > > > > > > > > > > > > > > progestins.> > > > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > > > > Normotension was defined as seated> > > > systolic b=> > > > > > > > > > >> > > > > > > > > >> > > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
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