Assessment of the Quantitative Value Usefulness of the Aldosterone-Renin Ratio (ARR) for Primary Aldosteronism (AQUARR) Study

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• 作者：Giuseppe Maiolino ; Sara Mareso…
• 关键词：Aldosterone ; renin ratio ; Primary aldosteronism ; Aldosterone ; producing adenoma ; Diagnosis
• 刊名：High Blood Pressure & Cardiovascular Prevention
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：23
• 期：1
• 页码：19-23
• 全文大小：442 KB
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• 作者单位：Giuseppe Maiolino (1)
  Sara Mareso (1)
  Valeria Bisogni (1)
  Giacomo Rossitto (1)
  Matteo Azzolini (1)
  Maurizio Cesari (1)
  Teresa Maria Seccia (1)
  Lorenzo Calò (2)
  Gian Paolo Rossi (1)
  
  1. Clinica dell’Ipertensione Arteriosa, DIMED-UOSD Ipertensione, University Hospital, University of Padua, via Giustiniani, 2, 35126, Padua, Italy
  2. Department of Medicine, UOC Nefrologia, University of Padua, Padua, Italy
  
• 刊物主题：Cardiology; Pharmacotherapy;
• 出版者：Springer International Publishing
• ISSN：1179-1985

文摘

Current guidelines recommend use of the aldosterone-renin ratio (ARR) for the case detection of primary aldosteronism (PA), the most common cause of secondary hypertension, in selected hypertensive patients. “Confirmatory” tests are then recommended in patients who tested positive at the ARR to exclude from further diagnostic work-up false positive results. Based on our experience we hypothesized that the ARR carries quantitative information, which can avoid the need of confirmatory tests. We herein describe a study protocol to identify the ARR cut-off value with a high specificity for the exclusion of aldosterone-producing adenoma (APA) based on analysis of two large prospectively collected datasets of patients in which a conclusive diagnosis of APA was made by the four corners criteria. This will also serve to investigate the diagnostic gain provided over this ARR cut-off value by one confirmatory test, the captopril challenge test. Hence, with this protocol we expect to identify an ARR cut-off value that might prevent further testing in patients with either a low or a high probability of APA. This could translate in a higher diagnostic accuracy and, by preventing unnecessary invasive testing, into a substantial saving of money, time, and resources.