Optimal Cut‐Off Values of the Aldosterone‐Renin Ratio in Different Age Groups for Primary Aldosteronism Screening

This study sought to establish age‐specific optimal cut‐off values for the aldosterone‐to‐renin ratio (ARR) in screening for primary aldosteronism (PA). The analysis included 281 patients with confirmed PA and 1242 with essential hypertension (EH), categorized into four age groups: ≤39, 40–49, 50–59, and ≥60 years. A positive correlation was observed between ARR and age in both patient groups. Receiver operating characteristic analysis determined the optimal ARR cut‐offs to be 2.3, 2.8, 3.1, and 3.6 for the respective age groups, with all demonstrating high diagnostic accuracy. Further evaluation revealed that for patients under 50‐years‐old, a unified ARR cut‐off of 2.4 provided high sensitivity and specificity, while for patients aged 50 or older, a cut‐off of 3.7 was more appropriate. In conclusion, the optimal ARR cut‐off for PA screening increases with age, and we recommend using a value of 2.4 for patients under 50 and 3.7 for those aged 50 or older to achieve superior diagnostic performance.