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HelpTest ID: AHPRU Antihypertension Panel, Random, Urine
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube: Plastic, 5-mL tube
Specimen Volume: 4 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative
Useful For
Aid in the management of hypertension, especially treatment resistant hypertension
Monitoring compliance in individuals prescribed antihypertensive drug therapy
As a screen to detect non-prescribed use of common diuretics
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Antihypertension Panel, Random, USpecimen Type
UrineSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 7 days |
Clinical Information
Adherence to antihypertensive medication dose and frequency is important for adequate hypertension control. Not taking medications as prescribed is a common and underappreciated cause of resistant hypertension. It can be challenging to suspect and discern medication nonadherence from history alone. This urine assay includes drug targets that are commonly prescribed for hypertension and allows for an objective assessment of whether a patient has taken a prescribed medication in the previous twenty-four hours. If not, a healthcare professional can explore the reason for noncompliance with the patient in a targeted fashion. If there are issues with patient tolerance of a given medication not previously appreciated, alternative regimens can be considered. This targeted information can also help avoid over prescription of additional medications and related complications.
This test can also be used as a screen to detect nonprescribed use of common diuretics.
Reference Values
Not detected: These drugs should not be present in untreated individuals.
Cutoff concentrations:
Amlodipine: 400 ng/mL
Atenolol: 800 ng/mL
Bumetanide: 40 ng/mL
Carvedilol: 40 ng/mL
Chlorthalidone: 4 ng/mL
Clonidine: 40 ng/mL
Furosemide: 4 ng/mL
Hydralazine: 400 ng/mL
Hydrochlorothiazide: 10 ng/mL
Labetalol: 40 ng/mL
Lisinopril: 1000 ng/mL
Losartan: 4 ng/mL
Metoprolol: 40 ng/mL
7-alpha-Thiomethylspironolactone: 10 ng/mL
Terazosin: 4 ng/mL
Torsemide: 40 ng/mL
Interpretation
Antihypertensive medications are reported as either detected or not detected, specific concentrations are not quantified.
This test measures urine concentrations of 7 alpha-thiomethylspironolactone, a major active metabolite of spironolactone. Detection of this metabolite indicates recent intake of spironolactone and can be used to assess patient compliance with spironolactone therapy.
Clinical Reference
1. Gupta P, Patel P, Strauch B, et al. Biochemical screening for nonadherence is associated with blood pressure reduction and improvement in adherence. Hypertension. 2017;70(5):1042-1048. doi:10.1161/Hypertensionaha
2. Jung O, Gechter JL, Wunder C, et al. Resistant hypertension? Assessment of adherence by toxicological urine analysis. J Hypertens. 2013;31(4):766-774. doi:10.1097/HJH.0b013e32835e2286
3. Tomaszewski M, White C, Patel P, et al. High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Heart. 2014;100(11):855-861. doi:10.1136/heartjnl-2013-305063
4. Peeters LEJ, Kappers MHW, Boersma E, et al. The effect of combining therapeutic drug monitoring of antihypertensive drugs with personalised feedback on adherence and resistant hypertension: the (RHYME-RCT) trial protocol of a multi-centre randomised controlled trial. BMC Cardiovasc Disord. 2023;23(1):87. doi:10.1186/s12872-023-03114-0
Day(s) Performed
Friday
Report Available
2 to 9 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80377
G0481 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| AHPRU | Antihypertension Panel, Random, U | 107229-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 621682 | Amlodipine, Random, U | 107228-9 |
| 621683 | Atenolol, Random, U | 3360-5 |
| 621684 | Bumetanide, Random, U | 3409-0 |
| 621685 | Carvedilol, Random, U | 107227-1 |
| 621686 | Chlorthalidone, Random, U | 3478-5 |
| 621687 | Clonidine, Random, U | 52960-2 |
| 621689 | Furosemide, Random, U | 3660-8 |
| 621690 | Hydralazine, Random, U | 16983-9 |
| 621691 | Hydrochlorothiazide, Random, U | 3676-4 |
| 621692 | Labetalol, Random, U | 3705-1 |
| 621693 | Lisinopril, Random, U | 107225-5 |
| 621694 | Losartan, Random, U | 107224-8 |
| 621695 | Metoprolol, Random, U | 3816-6 |
| 621696 | 7a-Thiomethylspironolactone, R, U | 12318-2 |
| 621697 | Terazosin, Random, U | 107223-0 |
| 621698 | Torsemide, Random, U | 107222-2 |
| 621688 | Interpretation, Random, U | 59462-2 |
Forms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.