“…Other reasons may include the wide and changing landscape of assays and the problem that published cut-off values are readily adopted by laboratories although there is a substantial inter-assay variation [26]. Recent papers have put a main focus on testing in primary aldosteronism and addressed these and other aspects [3,23,[27][28][29][30][31][32][33] and proposed ideas for possible solutions [34]. Ideally, antihypertensive medication should be switched to verapamil slow-release, hydralazine, prazosin, doxazosin, and terazosin [3].…”
Section: How To Diagnose Primary Aldosteronism?mentioning
confidence: 99%
“…Despite the fact that the outcome of a confirmation test may also be hampered by a number of uncertainties, each suspected case should undergo a confirmation test although the sensitivities and specificities range between 75 and 95 % for some tests only and do not necessarily exceed the accuracy rates of screening tests [3,55]. While these tests are described in detail elsewhere [3,30,33], some advantages and disadvantages of tests are discussed below. For additional information, see ▶table 2.…”
Section: Confirming the Diagnosis Of Pamentioning
confidence: 99%
“…The Brisbane and the Munich groups see a benefit from performing this test in sitting position, others combine it with a low-dose dexamethasone suppression test (▶table 2) [58,59]. Further discussion can be found elsewhere [30,33,34]. The great advantage of aldosterone measurements in 24-h urine samples after oral sodium loading is that it can be easily combined with the determination of cortisol (and profiling of other steroids) and (nor)metanephrine during the investigation for secondary hypertension or an adrenal mass and even assessment of sodium excretion, creatinine clearance and albuminuria in an outpatient setting.…”
Section: Measure or Circumstance Reasonmentioning
confidence: 99%
“…As the ARR is more specific when elevated despite ACE-inhibitor or AT1R-blocker therapy, the informative value of the ARR and blood aldosterone concentration after a captopril (CCT) or a losartan challenge (LCT) test reaches the standard of a confirmation test (▶table 2) [3,4,30]. There are, however, various test modifications and different assay methodology because of which it is recommended to analyze own experience.…”
The last years have seen substantial progress in primary aldosteronism (PA), which is the most common cause of secondary hypertension. Many programs have been established around the world to meet the needs in healthcare and the management of patients with PA according to published guidelines and clinical protocols. Systematic analysis of emerging data and meticulous scientific work have informed us on the molecular basis of the disease and helped to characterize hereditary forms of PA. Techniques have been developed to better diagnose PA and to establish genotype-phenotype relationships and their impact on hypertension. Studies have been undertaken to stratify patients for risk factors and to ensure quality of best medical treatment. This review focuses on some clinically relevant problems in characterizing autonomous aldosterone secretion and discusses testing and management strategies. Besides, this review puts the emphasis on some colorful studies not to pale soon beside an ever evolving painting background.
“…Other reasons may include the wide and changing landscape of assays and the problem that published cut-off values are readily adopted by laboratories although there is a substantial inter-assay variation [26]. Recent papers have put a main focus on testing in primary aldosteronism and addressed these and other aspects [3,23,[27][28][29][30][31][32][33] and proposed ideas for possible solutions [34]. Ideally, antihypertensive medication should be switched to verapamil slow-release, hydralazine, prazosin, doxazosin, and terazosin [3].…”
Section: How To Diagnose Primary Aldosteronism?mentioning
confidence: 99%
“…Despite the fact that the outcome of a confirmation test may also be hampered by a number of uncertainties, each suspected case should undergo a confirmation test although the sensitivities and specificities range between 75 and 95 % for some tests only and do not necessarily exceed the accuracy rates of screening tests [3,55]. While these tests are described in detail elsewhere [3,30,33], some advantages and disadvantages of tests are discussed below. For additional information, see ▶table 2.…”
Section: Confirming the Diagnosis Of Pamentioning
confidence: 99%
“…The Brisbane and the Munich groups see a benefit from performing this test in sitting position, others combine it with a low-dose dexamethasone suppression test (▶table 2) [58,59]. Further discussion can be found elsewhere [30,33,34]. The great advantage of aldosterone measurements in 24-h urine samples after oral sodium loading is that it can be easily combined with the determination of cortisol (and profiling of other steroids) and (nor)metanephrine during the investigation for secondary hypertension or an adrenal mass and even assessment of sodium excretion, creatinine clearance and albuminuria in an outpatient setting.…”
Section: Measure or Circumstance Reasonmentioning
confidence: 99%
“…As the ARR is more specific when elevated despite ACE-inhibitor or AT1R-blocker therapy, the informative value of the ARR and blood aldosterone concentration after a captopril (CCT) or a losartan challenge (LCT) test reaches the standard of a confirmation test (▶table 2) [3,4,30]. There are, however, various test modifications and different assay methodology because of which it is recommended to analyze own experience.…”
The last years have seen substantial progress in primary aldosteronism (PA), which is the most common cause of secondary hypertension. Many programs have been established around the world to meet the needs in healthcare and the management of patients with PA according to published guidelines and clinical protocols. Systematic analysis of emerging data and meticulous scientific work have informed us on the molecular basis of the disease and helped to characterize hereditary forms of PA. Techniques have been developed to better diagnose PA and to establish genotype-phenotype relationships and their impact on hypertension. Studies have been undertaken to stratify patients for risk factors and to ensure quality of best medical treatment. This review focuses on some clinically relevant problems in characterizing autonomous aldosterone secretion and discusses testing and management strategies. Besides, this review puts the emphasis on some colorful studies not to pale soon beside an ever evolving painting background.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.