Re: Making the Dx of the cause of high blood pressure.

[Guest guest]

That is Conn's usually unless you are aldo pigging our on Na and eating not much K.Need to get this message across. CE Grim MDOn Apr 18, 2010, at 7:40 AM, Francis Bill SUSPECTED PA wrote:Not all Dr look at the drop in K when adding HX as being a problem. In fact they say this is normal. Most will tell you to eat more bananas or give you K supplements.How much of a drop in K is normal and how much would indicate Conn's? The drop I had was from 4.2 to 3.2 on 25MG. > >>>>>> >>>>>> Hello...> >>>>>>> >>>>>> In the morning I wake up with a flat belly, have a cigarette > >>>>>> and it swells, is that a symptom of bp or cortisol? I wish I > >>>>>> knew what is going on > >>>>>>> >>>>>> I tried to go to the gym last night and was awake nearly all > >>>>>> night, face was round and had a temper and wired feeling > >>>>>>> >>>>>> If its to do with cortisol then I seem very sensitive to > >>>>>> anything that raises cortisol..> >>>>>>> >>>>>>> >>>>>> Sent using BlackBerry® from Orange> >>>>>>> >>>>>> > >>>>>> Date: Fri, 16 Apr 2010 06:21:21 -0000> >>>>>> To: <hyperaldosteronism >> >>>>>> Subject: Is the Aldosterone:Renin Ratio > >>>>>> Truly Reproducible?> >>>>>>> >>>>>>> >>>>>>> >>>>>> Is the Aldosterone:Renin Ratio Truly Reproducible?> >>>>>>> >>>>>>> >>>>>> J. Woodman> >>>>>> Department of General Practice, Flinders University, Adelaide, > >>>>>> Australia> >>>>>>> >>>>>> Arduino A. Mangoni> >>>>>>> >>>>>> Department of Clinical Pharmacology, Flinders University, > >>>>>> Adelaide, Australia> >>>>>>> >>>>>>> >>>>>>> >>>>>> An extract of the first 250 words of the full text is provided, > >>>>>> because this article has no abstract.> >>>>>>> >>>>>>> >>>>>> To the Editor:> >>>>>>> >>>>>> Rossi et al recently concluded that the aldosterone:renin ratio > >>>>>> (ARR) is reproducible.1 However, we think that several common > >>>>>> errors were performed in their data interpretation, as > >>>>>> described below.> >>>>>>> >>>>>> In the Bland-Altman plot B (Figure 1 in Reference 1), the large > >>>>>> differences in repeat measurements are overlooked on the basis > >>>>>> that only 7% of points lay outside of the between-test "95% > >>>>>> CIs," by which they imply the Bland-Altman "limits of > >>>>>> agreement." These are constructed using the mean differenc > >>>>>> e ±1.96 SDs, and so by definition alone, will always cont > >>>>>> ain 95% of the data and should certainly not, therefore, b > >>>>>> e regarded as evidence for good reproducibility. The latte > >>>>>> r should instead be qualitatively assessed by a careful cl > >>>>>> inical consideration of the magnitude of the 2 calculated > >>>>>> limits. This step is often omitted, as was the case here.> >>>>>>> >>>>>> The upper of the 2 "limits of agreement"2 in plot B is 2.1. > >>>>>> This equates to a ratio of 8.2 between the 2 measures because, > >>>>>> log(e)ARR1â€"log(e)ARR2=log(e)(ARR1/ARR2), and exp(2.1)= 8 > >>>>>> .2. Therefore, the ratio of repeat measurements may differ > >>>>>> by as much as 8.2. Had the authors drawn confidence limit > >>>>>> s for the limits of agreement, sometimes termed "tolerance > >>>>>> limits,"3 the ratios of repeat measures would be as high > >>>>>> as 10. This follows from the formula for the SE for the li > >>>>>> mits of agreement of (3s2/n)=0.097, where "s" is the SD of > >>>>>> the differences [0.92, ie, (2.1â€"0.3)/1.96], and "n" is > >>>>>> the sample size (268). The upper confidence limit for the > >>>>>> upper limit of agreementis . . . [Full Text of this Article]> >>>>>>> >>>>>>> >>>>>>> >>>>>>> >>>>>>> >>>>>>> >>>>>>> >>>>>> >>>>>> >>>>>> >>>>> >>>>> >>>>> >>>> >>>> >>>> >>> >>> >>> >> >> >>

[Guest guest]

Getting this message across doesn't seem like some I can do. I don't think they

teach this at Dartmouth Med school as all the Dr I deal with teach Dartmouth

Medical Students.

> > > >>>>>

> > > >>>>>> Hello...

> > > >>>>>>

> > > >>>>>> In the morning I wake up with a flat belly, have a cigarette

> > > >>>>>> and it swells, is that a symptom of bp or cortisol? I wish I

> > > >>>>>> knew what is going on

> > > >>>>>>

> > > >>>>>> I tried to go to the gym last night and was awake nearly all

> > > >>>>>> night, face was round and had a temper and wired feeling

> > > >>>>>>

> > > >>>>>> If its to do with cortisol then I seem very sensitive to

> > > >>>>>> anything that raises cortisol..

> > > >>>>>>

> > > >>>>>>

> > > >>>>>> Sent using BlackBerry® from Orange

> > > >>>>>>

> > > >>>>>> From: " MaxJasper " <maxjasper@>

> > > >>>>>> Date: Fri, 16 Apr 2010 06:21:21 -0000

> > > >>>>>> To: <hyperaldosteronism >

> > > >>>>>> Subject: Is the Aldosterone:Renin Ratio

> > > >>>>>> Truly Reproducible?

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>> Is the Aldosterone:Renin Ratio Truly Reproducible?

> > > >>>>>>

> > > >>>>>>

> > > >>>>>> J. Woodman

> > > >>>>>> Department of General Practice, Flinders University,

> > Adelaide,

> > > >>>>>> Australia

> > > >>>>>>

> > > >>>>>> Arduino A. Mangoni

> > > >>>>>>

> > > >>>>>> Department of Clinical Pharmacology, Flinders University,

> > > >>>>>> Adelaide, Australia

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>> An extract of the first 250 words of the full text is

> > provided,

> > > >>>>>> because this article has no abstract.

> > > >>>>>>

> > > >>>>>>

> > > >>>>>> To the Editor:

> > > >>>>>>

> > > >>>>>> Rossi et al recently concluded that the aldosterone:renin

> > ratio

> > > >>>>>> (ARR) is reproducible.1 However, we think that several common

> > > >>>>>> errors were performed in their data interpretation, as

> > > >>>>>> described below.

> > > >>>>>>

> > > >>>>>> In the Bland-Altman plot B (Figure 1 in Reference 1), the

> > large

> > > >>>>>> differences in repeat measurements are overlooked on the

> > basis

> > > >>>>>> that only 7% of points lay outside of the between-test " 95%

> > > >>>>>> CIs, " by which they imply the Bland-Altman " limits of

> > > >>>>>> agreement. " These are constructed using the mean differenc

> > > >>>>>> e ±1.96 SDs, and so by definition alone, will always cont

> > > >>>>>> ain 95% of the data and should certainly not, therefore, b

> > > >>>>>> e regarded as evidence for good reproducibility. The latte

> > > >>>>>> r should instead be qualitatively assessed by a careful cl

> > > >>>>>> inical consideration of the magnitude of the 2 calculated

> > > >>>>>> limits. This step is often omitted, as was the case here.

> > > >>>>>>

> > > >>>>>> The upper of the 2 " limits of agreement " 2 in plot B is 2.1.

> > > >>>>>> This equates to a ratio of 8.2 between the 2 measures

> > because,

> > > >>>>>> log(e)ARR1†" log(e)ARR2=log(e)(ARR1/ARR2), and exp(2.1)= 8

> > > >>>>>> .2. Therefore, the ratio of repeat measurements may differ

> > > >>>>>> by as much as 8.2. Had the authors drawn confidence limit

> > > >>>>>> s for the limits of agreement, sometimes termed " tolerance

> > > >>>>>> limits, " 3 the ratios of repeat measures would be as high

> > > >>>>>> as 10. This follows from the formula for the SE for the li

> > > >>>>>> mits of agreement of (3s2/n)=0.097, where " s " is the SD of

> > > >>>>>> the differences [0.92, ie, (2.1†" 0.3)/1.96], and " n " is

> > > >>>>>> the sample size (268). The upper confidence limit for the

> > > >>>>>> upper limit of agreementis . . . [Full Text of this Article]

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>

> > > >>>>

> > > >>>>

> > > >>>

> > > >>>

> > > >>>

> > > >>

> > > >>

> > > >>

> > > >

> > > >

> > > >

> > >

> >

> >

> >

>

[Guest guest]

Don't think I have had a complete metabolic panel done.

> >>>>

> >>>>> Hello...

> >>>>>

> >>>>> In the morning I wake up with a flat belly, have a cigarette and

> >>>>> it swells, is that a symptom of bp or cortisol? I wish I knew

> >>>>> what is going on

> >>>>>

> >>>>> I tried to go to the gym last night and was awake nearly all

> >>>>> night, face was round and had a temper and wired feeling

> >>>>>

> >>>>> If its to do with cortisol then I seem very sensitive to

> >>>>> anything that raises cortisol..

> >>>>>

> >>>>>

> >>>>> Sent using BlackBerry® from Orange

> >>>>>

> >>>>>

> >>>>> Date: Fri, 16 Apr 2010 06:21:21 -0000

> >>>>> To: <hyperaldosteronism >

> >>>>> Subject: Is the Aldosterone:Renin Ratio

> >>>>> Truly Reproducible?

> >>>>>

> >>>>>

> >>>>>

> >>>>> Is the Aldosterone:Renin Ratio Truly Reproducible?

> >>>>>

> >>>>>

> >>>>> J. Woodman

> >>>>> Department of General Practice, Flinders University, Adelaide,

> >>>>> Australia

> >>>>>

> >>>>> Arduino A. Mangoni

> >>>>>

> >>>>> Department of Clinical Pharmacology, Flinders University,

> >>>>> Adelaide, Australia

> >>>>>

> >>>>>

> >>>>>

> >>>>> An extract of the first 250 words of the full text is provided,

> >>>>> because this article has no abstract.

> >>>>>

> >>>>>

> >>>>> To the Editor:

> >>>>>

> >>>>> Rossi et al recently concluded that the aldosterone:renin ratio

> >>>>> (ARR) is reproducible.1 However, we think that several common

> >>>>> errors were performed in their data interpretation, as described

> >>>>> below.

> >>>>>

> >>>>> In the Bland-Altman plot B (Figure 1 in Reference 1), the large

> >>>>> differences in repeat measurements are overlooked on the basis

> >>>>> that only 7% of points lay outside of the between-test " 95%

> >>>>> CIs, " by which they imply the Bland-Altman " limits of

> >>>>> agreement. " These are constructed using the mean difference Â

> >>>>> ±1.96 SDs, and so by definition alone, will always contain 95%

> >>>>> of the data and should certainly not, therefore, be regarded as

> >>>>> evidence for good reproducibility. The latter should instead be

> >>>>> qualitatively assessed by a careful clinical consideration of

> >>>>> the magnitude of the 2 calculated limits. This step is often

> >>>>> omitted, as was the case here.

> >>>>>

> >>>>> The upper of the 2 " limits of agreement " 2 in plot B is 2.1. This

> >>>>> equates to a ratio of 8.2 between the 2 measures because,

> >>>>> log(e)ARR1†" log(e)ARR2=log(e)(ARR1/ARR2), and exp(2.1)= 8.2.

> >>>>> Therefore, the ratio of repeat measurements may differ by as

> >>>>> much as 8.2. Had the authors drawn confidence limits for the

> >>>>> limits of agreement, sometimes termed " tolerance limits, " 3 the

> >>>>> ratios of repeat measures would be as high as 10. This follows

> >>>>> from the formula for the SE for the limits of agreement of (3s2/

> >>>>> n)=0.097, where " s " is the SD of the differences [0.92, ie, (2.1â

> >>>>> € " 0.3)/1.96], and " n " is the sample size (268). The upper

> >>>>> confidence limit for the upper limit of agreementis . . . [Full

> >>>>> Text of this Article]

> >>>>>

> >>>>>

> >>>>>

> >>>>>

> >>>>>

> >>>>>

> >>>>>

> >>>>

> >>>>

> >>>>

> >>>

> >>>

> >>>

> >>

> >>

> >>

> >

> >

> >

> >

>

[Guest guest]

I do find it hard to find lab tests. I have them so I can search them. The VA

may use other names for blood tests like some other term then AKA SGOT I can

find other tests. Some that could be part of the metabolic panel like PO4 and

URIC A they seen to be listed in part of there own test panel.

> > > >>>>

> > > >>>>> Hello...

> > > >>>>>

> > > >>>>> In the morning I wake up with a flat belly, have a cigarette

> > and

> > > >>>>> it swells, is that a symptom of bp or cortisol? I wish I knew

> > > >>>>> what is going on

> > > >>>>>

> > > >>>>> I tried to go to the gym last night and was awake nearly all

> > > >>>>> night, face was round and had a temper and wired feeling

> > > >>>>>

> > > >>>>> If its to do with cortisol then I seem very sensitive to

> > > >>>>> anything that raises cortisol..

> > > >>>>>

> > > >>>>>

> > > >>>>> Sent using BlackBerry® from Orange

> > > >>>>>

> > > >>>>> From: " MaxJasper " <maxjasper@>

> > > >>>>> Date: Fri, 16 Apr 2010 06:21:21 -0000

> > > >>>>> To: <hyperaldosteronism >

> > > >>>>> Subject: Is the Aldosterone:Renin Ratio

> > > >>>>> Truly Reproducible?

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>> Is the Aldosterone:Renin Ratio Truly Reproducible?

> > > >>>>>

> > > >>>>>

> > > >>>>> J. Woodman

> > > >>>>> Department of General Practice, Flinders University, Adelaide,

> > > >>>>> Australia

> > > >>>>>

> > > >>>>> Arduino A. Mangoni

> > > >>>>>

> > > >>>>> Department of Clinical Pharmacology, Flinders University,

> > > >>>>> Adelaide, Australia

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>> An extract of the first 250 words of the full text is

> > provided,

> > > >>>>> because this article has no abstract.

> > > >>>>>

> > > >>>>>

> > > >>>>> To the Editor:

> > > >>>>>

> > > >>>>> Rossi et al recently concluded that the aldosterone:renin

> > ratio

> > > >>>>> (ARR) is reproducible.1 However, we think that several common

> > > >>>>> errors were performed in their data interpretation, as

> > described

> > > >>>>> below.

> > > >>>>>

> > > >>>>> In the Bland-Altman plot B (Figure 1 in Reference 1), the

> > large

> > > >>>>> differences in repeat measurements are overlooked on the basis

> > > >>>>> that only 7% of points lay outside of the between-test " 95%

> > > >>>>> CIs, " by which they imply the Bland-Altman " limits of

> > > >>>>> agreement. " These are constructed using the mean difference Â

> > > >>>>> ±1.96 SDs, and so by definition alone, will always contain 95%

> > > >>>>> of the data and should certainly not, therefore, be regarded

> > as

> > > >>>>> evidence for good reproducibility. The latter should instead

> > be

> > > >>>>> qualitatively assessed by a careful clinical consideration of

> > > >>>>> the magnitude of the 2 calculated limits. This step is often

> > > >>>>> omitted, as was the case here.

> > > >>>>>

> > > >>>>> The upper of the 2 " limits of agreement " 2 in plot B is 2.1.

> > This

> > > >>>>> equates to a ratio of 8.2 between the 2 measures because,

> > > >>>>> log(e)ARR1†" log(e)ARR2=log(e)(ARR1/ARR2), and exp(2.1)= 8.2.

> > > >>>>> Therefore, the ratio of repeat measurements may differ by as

> > > >>>>> much as 8.2. Had the authors drawn confidence limits for the

> > > >>>>> limits of agreement, sometimes termed " tolerance limits, " 3 the

> > > >>>>> ratios of repeat measures would be as high as 10. This follows

> > > >>>>> from the formula for the SE for the limits of agreement of

> > (3s2/

> > > >>>>> n)=0.097, where " s " is the SD of the differences [0.92, ie,

> > (2.1â

> > > >>>>> € " 0.3)/1.96], and " n " is the sample size (268). The upper

> > > >>>>> confidence limit for the upper limit of agreementis . . .

> > [Full

> > > >>>>> Text of this Article]

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>>

> > > >>>>

> > > >>>>

> > > >>>>

> > > >>>

> > > >>>

> > > >>>

> > > >>

> > > >>

> > > >>

> > > >

> > > >

> > > >

> > > >

> > >

> >

> >

> >

>