[Does the captopril test improve the diagnosis of primary hyperaldosteronism?].
Plasma concentrations of renin and aldosterone were measured before and 60 min after taking 25 mg captopril in 242 patients with arterial hypertension (124 men, 118 women, aged 51.9 +/- 12.7 years; unilateral aldosterone-producing adrenal adenoma in 8, idiopathic hyperaldosteronism in 16 and essential hypertension in 189). Basal plasma aldosterone levels were twice as high in those with adenoma or hyperaldosteronism (216.9 +/- 99.1 pg/ml and 256 +/- 123 pg/ml, respectively) as in those with essential hypertension (117.7 +/- 115 pg/ml). Basal renin levels in adenoma and idiopathic hyperaldosteronism (1 +/- 0.8 microU/ml and 2.6 +/- 1.9 microU/ml, respectively) were decreased compared with those in essential hypertension (13.1 +/- 14.2 microU/ml). The basal aldosterone/renin ratio was higher in adenoma (436 +/- 370 pg/microU) and idiopathic hyperaldosteronism (615 +/- 950 pg/microU) than in essential hypertension (52.9 +/- 151.3 pg/microU). The sensitivity of this ratio in combination with the aldosterone concentration was 100% for recognizing an adrenal adenoma, its specificity 92.7%. The mean plasma aldosterone level after captopril administration did not change in adenoma patients, but fell to 162 +/- 85 pg/ml (P less than 0.001) in those with idiopathic hyperaldosteronism. These data indicate that the captopril test contributes to distinguishing primary from idiopathic hyperaldosteronism.
Wambach
G
G
Medizinische Klinik II, Universität Köln.
Degenhardt
S
S
Bönner
G
G
Stimpel
M
M
Grimm
U
U
Krone
W
W
D000236:Adenoma / Q000097:blood / Q000175:diagnosis / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D000450:Aldosterone / Q000097:blood / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis*; D006973:Hypertension / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012680:Sensitivity and Specificity
D000450:Aldosterone; D002216:Captopril; D012083:Renin
Verbessert der Captopril-Test die Diagnostik des primären Hyperaldosteronismus?