Age-Related Cutoffs of Plasma Aldosterone/Renin Concentration for Primary Aldosteronism Screening

[摘要] Aim. This retrospective study is aimed at investigating whether aldosterone-renin ratio (ARR) cutoffs calculated by the plasma aldosterone concentration (PAC)/plasma renin concentration (PRC) should be set differently in patients of different ages. Methods. 521 hypertensive patients were screened for primary aldosteronism (PA) by the PAC/PRC. 174 patients diagnosed with PA and 311 patients with essential hypertension (EH) were included in the final analysis. Subjects were subdivided into four age groups 40, 4049, 5059, and 60 years old. Results. The accuracy of the ARR varied greatly among the different age groups. An ARR of 3.7(ng/dl)/(IU/ml) had a sensitivity of 100 and a specificity of 80 in patients60 years old. With this cutoff, the sensitivities in patients40, 4049, and 5059 years old were 74, 82, and 87, respectively, and the specificities were 94, 95, and 94, respectively. To achieve a sensitivity higher than 90, the ARR cutoff needed to be lowered to 2.0(ng/dl)/(IU/ml) for patients 4049 and 5059 years old, resulting in sensitivities of 90 and 95, respectively, and specificities of 80 and 84, respectively. To achieve a sensitivity higher than 90, the ARR cutoff needed to be lowered to 1.0(ng/dl)/(IU/ml) for patients40 years old, resulting in a sensitivity of 90 and a specificity of 82. Conclusions. An ARR of 3.7(ng/dl)/(IU/ml) is optimal for patients60 years; for patients 4059 years, the optimal ARR cutoff is 2.0; for those younger than 40 years, an ARR of 1.0 may be more reasonable.

[学科分类] 内分泌与代谢学