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Diagnostic evaluation of plasma aldosterone concentration to plasma renin activity ratio in primary aldosteronism

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Abstract

Using the plasma aldosterone concentration to plasma renin activity ratio (PAC/PRA ratio) as the screening test of choice for primary aldosteronism in hypertensive patients, we studied the clinical characteristics and the diagnostic value of PAC/PRA ratio in primary aldosteronism. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) levels were measured by radioimmunoassay in 902 hypertensive patients from out-patient clinics or hospitals. One hundred and twenty-six suspected primary aldosteronism patients whose PAC/PRA ratio was > 25 ng/dL/ng/mL/hr had a lamellar computed tomography (CT) scan in the adrenal gland and follow-up visits. The proportion of primary aldosteronism in hypertensive patients was 14% (126/902). There were 54 patients with unilateral or bilateral hyperplasia and 25 patients with adenoma according to the CT scan. 39% (49/126) of the patients with primary aldosteronism had hypokalemia. Twenty-five patients received surgical treatment. The efficacy and cure rates were 100% (25/25) and 48% (12/25), respectively. The effective rate of aldactone and the single-drug cure rate were 89% (48/54) and 24% (13/54), respectively. Primary aldosteronism affects over 10% of hypertensive patients in China. The PAC/PRA ratio can be considered as a routine screening test in hypertensives, especially resistant hypertensive patients and a high PAC/PRA ratio is an invaluable index in primary aldosteronism diagnosis.

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Authors and Affiliations

  1. Cardiovascular Department of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Huilan Zhang & Daowen Wang

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  1. Huilan Zhang
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  2. Daowen Wang
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Correspondence to Daowen Wang.

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Translated from Chinese Journal of Cardiology, 2006, 34(10): 873–876 [译自: 中华心血맜病杂志]

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Zhang, H., Wang, D. Diagnostic evaluation of plasma aldosterone concentration to plasma renin activity ratio in primary aldosteronism. Front. Med. China 2, 11–14 (2008). https://doi.org/10.1007/s11684-008-0003-4

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  • DOI: https://doi.org/10.1007/s11684-008-0003-4

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