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Exp Clin Endocrinol Diabetes 2002; 110(2): 80-85
DOI: 10.1055/s-2002-23491
Articles

© Johann Ambrosius Barth

Ratio of serum aldosterone to plasma renin concentration in essential hypertension and primary aldosteronism

S. Trenkel 1 , C. Seifarth 2 , H. Schobel 3 , E. G. Hahn 2 , J. Hensen 4
  • 1 Department of Pediatrics, Kinderkrankenhaus auf der Bult, Hannover, Germany
  • 2 Department of Internal Medicine I, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
  • 3 Department of Internal Medicine IV, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
  • 4 Department of Medicine, Klinikum Hannover Nordstadt, Germany
Further Information

Publication History

received 27 August 2001 first decision 03 October 2001

accepted 05 November 2001

Publication Date:
27 March 2002 (online)

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Summary

The ratio of serum aldosterone to plasma renin activity (PRA) has been proposed as sensitive screening method in the diagnosis of primary aldosteronism under random conditions. However, the method for determination of renin activity is hampered by the necessity of ice cooling during storage and transport. The present study was therefore conducted to examine the ratio of serum aldosterone to plasma renin concentration (ARR) and its usefulness in diagnosis of primary aldosteronism under ambulatory conditions and given antihypertensive medication. 146 patients with arterial hypertension who consecutively attended the outpatient clinic were studied prospectively. Patients with secondary hypertension besides primary aldosteronism were not included in the series. 37 normotensive patients served as control. Also, 17 patients with known primary aldosteronism were retrospectively examined. Among the hypertensive group 2 patients with Conn's syndrome were newly detected (1.4%). ARR was 7.92 ± 6.04 [pg/ml]/[pg/ml] in normotensive controls (range from 2.03 to 26.98), 14.61 ± 18.50 [pg/ml]/[pg/ml] in patients with essential hypertension (n = 144, range from 0.41 to 115.45) and 155.92 ± 127.84 [pg/ml]/[pg/ml] in patients with primary aldosteronism (n = 19, range from 6.75 to 515). 17 of the 19 patients with Conn's syndrome had an ARR of more than 50. Under ongoing drug treatment this represents a sensitivity of 89% and a specificity of 96%. Sensitivity decreased to 84% and specificity increased to 100% when a second criteria (aldosterone ≥ 200 pg/ml) was included. In summary, ARR using renin concentration is a useful screening parameter for primary aldosteronism.

Key words:

Primary aldosteronism - Aldosterone renin ratio - Plasma renin concentration

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Prof. Dr. med. J. Hensen

Department of Medicine

Klinikum Hannover Nordstadt

Haltenhoffstr. 41

D-30167 Hannover

Germany

Email: johannes.hensen.nordstadt@klinikum-hannover.de