{'fraction_non_alphanumeric': 0.04231166150670795, 'fraction_numerical': 0.0196078431372549, 'mean_word_length': 5.617747440273037, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A14580 Predictors of the results of the diagnostic tests for the primary hyperaldosteronism in patients with hypertension and an aldosterone-to-renin ratio greater than 20

Objectives: Our aim is to determine which surrogate markers can predict the confirmatory tests for the diagnosis of primary hyperaldosteronism (PA). Methods: The Secondary Hypertension Registry Investigation in Mie Prefecture (SHRIMP) study has sequentially and prospectively recruited 103 patients with hypertension with an aldosterone to renin ratio (ARR) greater than 20, evaluated the differences among essential hypertension (EHT), idiopathic hyperaldosteronism (IHA), and aldosterone-producing adenoma (APA), and analyzed the predictors for the confirmatory tests. The patients underwent saline-loading, captopril-challenge, and upright furosemide-loading tests. Carotid, renovascular, and cardiac echography, brachial ankle pulse wave velocity (baPWV), endothelial function, nocturnal blood pressure decline, and apnea hypopnea index were evaluated. Results: Multivariate regression analyses showed plasma aldosterone concentration (PAC) and ARR on screening were strong predictors of saline and captopril tests, respectively. Urine albumin to gram creatinine ratio (U-Alb/gCre) and beta2-microglobulin were independent predictors for the captopril test. The estimated saline PAC by the equation, = 25.38 + 0.537*PAC − 6.6*K + 0.023*ARR, was highly correlated with the real value (r = 0.830, P < 0.000001). Patients with IHA were older and had glucose intolerance, increased U-Alb/gCre and resistive indexes. Left atrial dimension and baPWV were independent predictors for diagnostic tests. In patients with APA, E/E’ and the addition of alpha blockers were independent predictors of diagnostic tests. Conclusion: Our proposed equation to estimate saline PAC may be useful. IHA and APA may contribute to confirmatory tests and organ damage in different ways.