This is an observational study compares the positivity rates of two tests for screening for primary aldosteronism: plasma aldosterone renin ratio and 24-hour urine aldosterone in patients with young-onset hypertension with or without other clinical features of primary aldosteronism.
Plasma aldosterone and renin measurements are subject to significant intra-individual variability, including variation related to posture, time of day and sodium balance. Aldosterone secretion is not constant and may be subject to diurnal variation. As such one-off testing of ARR, does not consider the salt status of the individual necessitating repetition of tests to ensure false negative or false positive test results are ruled out. The value of accumulated aldosterone in a 24-hour sample has the advantage that it does not depend on circadian variation. This pilot observational study will help establish the positivity rates of both standard plasma aldosterone renin ratio and 24-hour urine aldosterone, and the degree to which they correlate but will help establish if untargeted screening in young-onset hypertension is feasible and test the robustness of current standard guidelines for primary aldosteronism screening and case confirmation.
Study Type
OBSERVATIONAL
Enrollment
120
Vascular Research Clinic, Adenbrooke's Centre of Clinical Investigation, Addenbrooke's Hospital
Cambridge, United Kingdom
RECRUITINGRates of positive and negative, Aldosterone renin ratio and 24-hr urine aldosterone in unselected patients with hypertension and in patients with suspected primary aldosteronism
Time frame: 1 year
Degree of agreement between a positive/negative ARR and a positive/negative 24-hr urine aldosterone
Time frame: 1 year
Number of patients who required oral salt loading
Time frame: 1 year
The predictive value of a positive aldosterone renin ratio or 24-hr urine aldosterone with a positive confirmatory test
Time frame: 1 year
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