The Aldosterone-to-Renin Ratio as a Screening Test in Primary Aldosteronism

2021 ◽  
Vol 14 (63) (1) ◽  
pp. 29-36
Author(s):  
Manuela Mocanu ◽  
Claudia Alexandrina Irimie ◽  
Mihai Stelian Vârciu ◽  
Marius Irimie
Keyword(s):  
Primary Aldosteronism ◽  
Screening Test ◽  
Target Population ◽  
Secondary Hypertension ◽  
Primary Hypertension ◽  
Primary Hyperaldosteronism ◽  
Common Causes ◽  
Aldosterone To Renin Ratio

Primary hyperaldosteronism is one of the most common causes of secondary hypertension and it is associated with a higher risk of developing extracardiac complications than that of people diagnosed with primary hypertension. We present a six-month study done at the MedLife Hospital in Brașov on 62 patients who had one or more indications for primary hyperaldosteronism screening. The main conclusions drawn from this study are that there is a strong need for starting screening in primary hyperaldosteronism from an earlier age, as the target population can have a high vulnerability from a cardiovascular and a renal standpoint and that the aldosterone-to-renin ratio screening test should be recommended to a higher number of people in the target population, the positivity rate in the group studied being 47%.

scholarly journals Aldosterone to Renin Ratio as Screening Tool in Primary Aldosteronism

2018 ◽  
Vol 127 (02/03) ◽  
pp. 84-92
Author(s):  
Katharina Schilbach ◽  
Riia Junnila ◽  
Martin Bidlingmaier
Keyword(s):  
Primary Aldosteronism ◽  
Screening Test ◽  
Screening Tool ◽  
Secondary Hypertension ◽  
Hypertensive Patients ◽  
Assay Methods ◽  
Aldosterone To Renin Ratio

AbstractPrimary aldosteronism (PA) is a severe and often underdiagnosed form of secondary hypertension. Determining the aldosterone to renin ratio (ARR) in hypertensive patients has been shown to be a valuable screening test for identification of patients suffering from PA. Since the introduction of a more widespread ARR screening the number of PA patients significantly increased worldwide. Interpretation of ARR might be challenging: Several factors from posture to interfering drugs affect the ARR and need to be taken into account when collecting samples. In addition, the wide variety of available assay methods and lack of well-established cut-offs present a challenge to the clinician. This review discusses the usefulness and possible difficulties of ARR screening.

Primary Aldosteronism: Novel Insights

2020 ◽  
Vol 16 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Konstantinos Stavropoulos ◽  
Konstantinos Imprialos ◽  
Vasilios Papademetriou ◽  
Charles Faselis ◽  
Kostas Tsioufis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Molecular Basis ◽  
Diagnostic Procedure ◽  
Secondary Hypertension ◽  
Future Research ◽  
The Novel ◽  
Future Perspectives ◽  
Common Causes ◽  
Existing Data

Background: Primary aldosteronism is one of the most common causes of secondary hypertension. Patients with this endocrine syndrome are at increased cardiovascular risk, higher than hypertensive individuals with equal blood pressure levels. Objectives: The study aimed to thoroughly present and critically discuss the novel insights into the field of primary aldosteronism, focusing on the clinically meaningful aspects. Method: We meticulously evaluated existing data in the field of primary aldosteronism in order to summarize future perspectives in this narrative review. Results: Novel data suggests that a subclinical form of primary aldosteronism might exist. Interesting findings might simplify the diagnostic procedure of the disease, especially for the localization of primary aldosteronism. The most promising progress has been noted in the field of the molecular basis of the disease, suggesting new potential therapeutic targets. Conclusion: Several significant aspects are at early stages of evaluation. Future research is essential to investigate these well-promising perspectives.

Test characteristics of the aldosterone-to-renin ratio as a screening test for primary aldosteronism

2014 ◽  
Vol 32 (1) ◽  
pp. 115-126 ◽  
Author(s):  
Pieter M. Jansen ◽  
Bert-Jan H. van den Born ◽  
Wijnanda J. Frenkel ◽  
Emile L.E. de Bruijne ◽  
Jaap Deinum ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Screening Test ◽  
Test Characteristics ◽  
Aldosterone To Renin Ratio

scholarly journals A case of primary aldosteronism with a negative aldosterone-to-renin ratio

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fengyi Liu ◽  
Liang Wang ◽  
Yanchun Ding
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Screening Method ◽  
Organ Damage ◽  
Secondary Hypertension ◽  
Cardiovascular Damage ◽  
Aldosterone To Renin Ratio ◽  
Clinical Conditions

Abstract Background Primary aldosteronism (PA), as a cause of secondary hypertension, can cause more serious cardiovascular damage than essential hypertension. The aldosterone-to-renin ratio (ARR) is recommended as the most reliable screening method for PA, but ARR screening is often influenced by many factors. PA cannot be easily excluded when negative ARR. Case presentation We report the case of a 45-year-old Chinese man with resistant hypertension. Three years ago, he underwent a comprehensive screening for secondary hypertension, including the ARR, and the result was negative. After that, the patient's blood pressure was still poorly controlled with four kinds of antihypertensive drugs, the target organ damage of hypertension progressed, and hypokalaemia was difficult to correct. When the patient was hospitalized again for comprehensive examination, we found that aldosterone levels had significantly increased, although the ARR was negative. An inhibitory test with saline was further carried out, and the results suggested that aldosterone was not inhibited; therefore, PA was diagnosed. We performed a unilateral adenoma resection for this patient, and spironolactone was continued to control blood pressure. After the operation, blood pressure is well controlled, and hypokalaemia is corrected. Conclusion When the ARR is negative, PA cannot be easily excluded. Comprehensive analysis and diagnosis should be based on the medication and clinical conditions of patients.

Primary Aldosteronism Complicated by Hypokalemic Rhabdomyolysis. A Clinical Case

2019 ◽  
Vol 2 (3) ◽  
pp. 110-114
Author(s):  
K. Skaletsky ◽  
E. Kosmacheva ◽  
N. Kizhvatova ◽  
V. Porhanov
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Primary Aldosteronism ◽  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Secondary Hypertension ◽  
Acute Cerebrovascular Accident ◽  
Initial Stage ◽  
Common Causes

Abstract Primary aldosteronism (PA) is one of the most common causes of secondary hypertension, which in less than half of cases is manifested by hypokalemia. In cases where hypokalemia becomes significant, it can lead to muscle weakness or even paralysis. Such patients are often unsuccessfully treated by neurologists or rheumatologists. In our clinical case a 61 year old patient had rapidly developing symptoms, which were interpreted by ambulance paramedics as an acute cerebrovascular accident. Since the patient was admitted to a multidisciplinary hospital, he was examined by doctors of different specialties, the diagnostic direction was set correctly and rhabdomyolysis was already detected at the initial stage. We excluded various causes of myopathy, which ultimately led us to the most likely cause of this condition - hypokalemia, and explained muscle symptoms. As a result, it helped us to identify the correct diagnosis - aldosteronism. The patient quickly recovered due to the prescribed therapy and felt good, and therefore refused surgical treatment (adrenalectomy), which, perhaps, would allow him to fully recover. Thus, a rare clinical case of differential diagnosis and successful drug treatment of PA with hypokalemia, which is manifested by rhabdomyolysis, is presented.

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