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Captopril suppression: Limitations for confirmation of primary aldosteronism.

In English

Författare

Summary, in English

INTRODUCTION: : The aldosterone/renin ratio (ARR) is the first line screening test for primary aldosteronism (PA). However, in hypertensive patients with an increased ARR, PA needs to be confirmed by other means. METHODS: : A 25 mg oral captopril test was performed in 16 healthy subjects to obtain reference values for aldosterone and ARR at 120 minutes after the test. Subsequently these data were applied to 46 hypertensive patients screened for PA with an increased ARR. RESULTS: : At 120 minutes after the captopril test ARR decreased in healthy subjects within a narrow range, but remained high in patients with PA and in patients with primary hypertension, especially for those with low renin characteristics. At 120 minutes after captopril, the range of ARR in primary hypertensive patients overlapped in 88% of the cases with the range of the ARR in the PA patients. Sensitivity and specificity of basal ARR and ARR after the captopril test to diagnose PA, calculated as receiver operator characteristics, showed an area under the curve of 0.595 for basal ARR and 0.664 for ARR at 120 minutes after the test. CONCLUSION: : The ARR at 120 minutes after the captopril test is only marginally better than basal ARR in diagnosing PA in hypertensive patients screened with an increased ARR. Owing to an overall limited capacity to clearly discriminate PA from primary hypertension, the test could not therefore be recommended for the confirmatory diagnosis of PA.

Publiceringsår

2011

Språk

Engelska

Sidor

326-332

Publikation/Tidskrift/Serie

Journal of the Renin-Angiotensin-Aldosterone System

Volym

12

Dokumenttyp

Artikel i tidskrift

Förlag

JRAAS Ltd.

Ämne

  • Other Clinical Medicine
  • Pharmacology and Toxicology
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Surgery
  • Medicinal Chemistry

Status

Published

Forskningsgrupp

  • Family Medicine and Community Medicine

ISBN/ISSN/Övrigt

  • ISSN: 1752-8976