Aldosterone-producing adenoma and other surgically correctable forms of primary aldosteronism

Table 2 Prevalence of a raised aldosterone to renin ratio and of aldosterone-producing adenomas in referral samples or samples from a large community

Source and first author	ARR threshold, ng/dL per ng/mL.h^-1	Subjects tested, n	Raised ARR, %	Confirmed PA, %	Proven adenoma, %
Community sample of hypertensive and non-hypertensive subjects
Newton-Cheh C, 2007[4]	21*
Men		1574	7	NR	NR
Women		1752	13	NR	NR
Referral samples of >1000 hypertensive patients
Nishikawa T, 2000[5]	20	1020	6.4	NR	4.2
Rossi E, 2002[10]	35	1046	12.8	6.3	1.5
Rossi GP, 2006[7]	40	1125	20.4	11.2	4.8
Fogari R, 2007[8]	25	3000	22.8	5.9	1.8
Douma S, 2008[9]	30	1616	20.9	11.3	NR

ARR: aldosterone to renin ratio. PA: primary aldosteronism
Screening tests were considered positive on the basis of a high ARR alone [5, 7–9], a composite criterion[7], or the combination of a high ARR and a plasma aldosterone concentration of 416 pmol/l (15.0 ng/dL) or more[9]. PA was generally confirmed by a sodium suppression test.
* Direct renin concentration (mU/l) determined by an automated method was converted to plasma renin activity using a conversion factor of 8.2 (see Funder JW et al, 2008[3])

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