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Captopril v Aldosterone to Plasma Renin Activity Ratio in Screening for Primary Aldosteronism

Captopril v Aldosterone to Plasma Renin Activity Ratio in Screening for Primary Aldosteronism Abstract To the Editor. —A variety of tests have been developed to help diagnose aldosterone-producing adenoma (APA) and distinguish it from idiopathic hyperaldosteronism (IHA). Recently, in the November Archives (1981;141: 1589-1593), Hiramatsu et al described a simple screening test to identify APA, which is based on a high plasma aldosterone to plasma renin activity (A-PRA) ratio and is claimed to be unaffected by various antihypertensive drug regimens. Unfortunately, the authors had no patients with IHA for comparison, and they gave no clinical details about the 11 patients who, despite high A-PRA ratios, did not have APA.We tested a number of screening methods on a 51-year-old man with IHA, including the one proposed by Hiramatsu et al. This patient had had hypertension for 15 years, and, sincefirst seen in our clinic six years ago, his serum potassium level had been consistently less than 2.9 mEq/L, except when treated with spironolactone. The Table shows the patient's References 1. Mantero F, Fallo F, Opocher G, et al: Effect of angiotensin II and converting enzyme inhibitor (captopril) on blood pressure, plasma renin activity and aldosterone in primary aldosteronism. Clin Sci 1981;61:289S-293S. 2. Streeten DPB, Tomycz N, Anderson GN: Reliability of screening methods for the diagnosis of primary aldosteronism. Am J Med 1979;67:403-413.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Captopril v Aldosterone to Plasma Renin Activity Ratio in Screening for Primary Aldosteronism

Archives of Internal Medicine , Volume 142 (12) – Nov 1, 1982

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340250197039
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —A variety of tests have been developed to help diagnose aldosterone-producing adenoma (APA) and distinguish it from idiopathic hyperaldosteronism (IHA). Recently, in the November Archives (1981;141: 1589-1593), Hiramatsu et al described a simple screening test to identify APA, which is based on a high plasma aldosterone to plasma renin activity (A-PRA) ratio and is claimed to be unaffected by various antihypertensive drug regimens. Unfortunately, the authors had no patients with IHA for comparison, and they gave no clinical details about the 11 patients who, despite high A-PRA ratios, did not have APA.We tested a number of screening methods on a 51-year-old man with IHA, including the one proposed by Hiramatsu et al. This patient had had hypertension for 15 years, and, sincefirst seen in our clinic six years ago, his serum potassium level had been consistently less than 2.9 mEq/L, except when treated with spironolactone. The Table shows the patient's References 1. Mantero F, Fallo F, Opocher G, et al: Effect of angiotensin II and converting enzyme inhibitor (captopril) on blood pressure, plasma renin activity and aldosterone in primary aldosteronism. Clin Sci 1981;61:289S-293S. 2. Streeten DPB, Tomycz N, Anderson GN: Reliability of screening methods for the diagnosis of primary aldosteronism. Am J Med 1979;67:403-413.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1982

References