The plasma aldosterone to plasma renin activity ratio provided complete separation of patients with primary aldosteronism from normal and essential hypertensive groups.
Cross-Sectional (n=759)
Does the plasma aldosterone to plasma renin activity ratio accurately diagnose and differentiate subtypes of primary aldosteronism in normotensive and hypertensive subjects?
The plasma aldosterone to plasma renin activity ratio is a simple and effective screening and diagnostic tool for identifying and subtyping primary aldosteronism.
BACKGROUND: To develop a simple screening and diagnostic test for primary aldosteronism and to compare it with established techniques. DESIGN: Comparison of several techniques for screening, diagnosis, and differentiation of primary aldosteronism using normotensive and hypertensive subjects. METHODS: Four hundred thirty-four normotensive subjects, 263 essential hypertensive subjects, 48 subjects with primary aldosteronism due to a unilateral adrenal adenoma, and 14 in whom primary aldosteronism was associated with findings of bilateral hyperaldosteronism were studied. Plasma renin activity and plasma aldosterone were measured in venous blood obtained at 8 AM after 2 hours of ambulation and compared with established suppressive (plasma aldosterone) and stimulatory (plasma renin activity) maneuvers used for the diagnosis of primary aldosteronism. RESULTS: The ratio of plasma aldosterone to plasma renin activity provided complete separation of patients with primary aldosteronism from the normal and essential hypertensive groups. Moreover, based on the use of traditional localizing procedures separating unilateral hyperaldosteronism due to a solitary adenoma from bilateral hyperaldosteronism, confirmed by surgical intervention in the former subgroup, the ratio provided differentiation of these two forms of primary aldosteronism. CONCLUSIONS: The use of the plasma aldosterone to plasma renin activity ratio appears to be useful in the screening, diagnosis, and differentiation of unilateral and bilateral forms of primary aldosteronism. These observations may also be applicable to patients receiving some antihypertensive medications.
Myron H. Weinberger (Mon,) conducted a cross-sectional in Primary aldosteronism (n=759). Plasma aldosterone to plasma renin activity ratio vs. Established suppressive and stimulatory maneuvers was evaluated on Separation of patients with primary aldosteronism from normal and essential hypertensive groups, and differentiation of subtypes. The plasma aldosterone to plasma renin activity ratio provided complete separation of patients with primary aldosteronism from normal and essential hypertensive groups.