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Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care

Primary aldosteronism (PA) is the most common and potentially curable form of secondary hypertension, affecting 5–10% of primary care patients with hypertension. Primary care physicians have an important role in initiating the screening for PA in patients with hypertension and referring to a special...

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Autores principales: Ariens, Joshua, Horvath, Andrea R., Yang, Jun, Choy, Kay Weng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242901/
https://www.ncbi.nlm.nih.gov/pubmed/35622194
http://dx.doi.org/10.1007/s12020-022-03084-x
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author Ariens, Joshua
Horvath, Andrea R.
Yang, Jun
Choy, Kay Weng
author_facet Ariens, Joshua
Horvath, Andrea R.
Yang, Jun
Choy, Kay Weng
author_sort Ariens, Joshua
collection PubMed
description Primary aldosteronism (PA) is the most common and potentially curable form of secondary hypertension, affecting 5–10% of primary care patients with hypertension. Primary care physicians have an important role in initiating the screening for PA in patients with hypertension and referring to a specialist service depending on the screening test results. The currently recommended screening test for PA is the plasma aldosterone-to-renin ratio (ARR). Test results are influenced by medications so careful patient preparation is required including adjusting existing antihypertensive medications to avoid diagnostic errors. A range of laboratory method-dependent ARR thresholds are used for the screening of PA around the world. Periodic clinical audits and case reviews by clinicians and the laboratory may help refine the local thresholds. Patients with an abnormally elevated ARR should be referred to a specialist for confirmatory testing while patients with a high pre-test probability but a normal ARR could have a repeat test in view of the within-individual variability. Despite the heterogenous ARR thresholds, measuring the ARR is still more likely to detect PA than not screening at all.
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spelling pubmed-92429012022-07-01 Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care Ariens, Joshua Horvath, Andrea R. Yang, Jun Choy, Kay Weng Endocrine Review Primary aldosteronism (PA) is the most common and potentially curable form of secondary hypertension, affecting 5–10% of primary care patients with hypertension. Primary care physicians have an important role in initiating the screening for PA in patients with hypertension and referring to a specialist service depending on the screening test results. The currently recommended screening test for PA is the plasma aldosterone-to-renin ratio (ARR). Test results are influenced by medications so careful patient preparation is required including adjusting existing antihypertensive medications to avoid diagnostic errors. A range of laboratory method-dependent ARR thresholds are used for the screening of PA around the world. Periodic clinical audits and case reviews by clinicians and the laboratory may help refine the local thresholds. Patients with an abnormally elevated ARR should be referred to a specialist for confirmatory testing while patients with a high pre-test probability but a normal ARR could have a repeat test in view of the within-individual variability. Despite the heterogenous ARR thresholds, measuring the ARR is still more likely to detect PA than not screening at all. Springer US 2022-05-27 2022 /pmc/articles/PMC9242901/ /pubmed/35622194 http://dx.doi.org/10.1007/s12020-022-03084-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review
Ariens, Joshua
Horvath, Andrea R.
Yang, Jun
Choy, Kay Weng
Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title_full Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title_fullStr Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title_full_unstemmed Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title_short Performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
title_sort performance of the aldosterone-to-renin ratio as a screening test for primary aldosteronism in primary care
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242901/
https://www.ncbi.nlm.nih.gov/pubmed/35622194
http://dx.doi.org/10.1007/s12020-022-03084-x
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