Plasma aldosterone to renin ratio for the detection of primary aldosteronism in patients with drug‐resistant hypertension

Choy, Kay W; Libianto, Renata; Simpson, Ian; Yang, Jun

doi:10.5694/mja2.51487

Topics

Cardiovascular diseases

Endocrine system diseases

1 Northern Hospital Epping, Melbourne, VIC
2 Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Melbourne, VIC
3 Monash Health, Melbourne, VIC
4 Monash Health Pathology, Melbourne, VIC

Correspondence: jun.yang@hudson.org.au

Acknowledgements:

We acknowledge the care offered to the patient by the team of nurses (Elise Forbes and Peta Nuttall), endocrinologists (Peter Fuller and Jimmy Shen), radiologists (Winston Chong and Ken Lau), chemical pathologists (James Doery and Zhong Lu) and endocrine surgeons (Simon Grodski and James Lee) through the Endocrine Hypertension Service at Hudson Institute of Medical Research and Monash Health. We also thank William (Bill) Rainey (Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, USA) for sharing his laboratory’s protocol for CYP11B2 adrenal staining, and thank Monash Pathology and Piero Nelva for establishing the protocol at Monash Health.

Competing interests:

No relevant disclosures.

1. Stowasser M, Gordon RD. Primary aldosteronism: changing definitions and new concepts of physiology and pathophysiology both inside and outside the kidney. Physiol Rev 2016; 96: 1327–1384.
2. Libianto R, Fuller PJ, Young MJ, Yang J. Primary aldosteronism is a public health issue: challenges and opportunities. J Hum Hypertens 2020; 34: 478–486.
3. Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016; 101: 1889–1916.
4. Monticone S, D’Ascenzo F, Moretti C, et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta‐analysis. Lancet Diabetes Endocrinol 2018; 6: 41–50.
5. Gurgenci T, Geraghty S, Wolley M, Yang J. Screening for primary aldosteronism: how to adjust existing antihypertensive medications to avoid diagnostic errors. Aust J Gen Pract 2020; 49: 127–131.
6. Maiolino G, Rossitto G, Bisogni V, et al. Quantitative value of aldosterone‐renin ratio for detection of aldosterone‐producing adenoma: the aldosterone‐renin ratio for primary aldosteronism (AQUARR) study. J Am Heart Assoc 2017; 6: e005574.
7. Libianto R, Russell GM, Stowasser M, et al. Detecting primary aldosteronism in Australian primary care: a prospective study. Med J Aust 2022; https://doi.org/10.5694/mja2.51438 [Epub ahead of print].

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