Angiotensin sensitivity test revisited.
OBJECTIVE
To determine the validity of a single angiotensin sensitivity test as predictor of pregnancy-induced hypertension with special reference to the dietary sodium intake at the time of testing.


METHODS
The angiotensin sensitivity test was successfully performed at 32 weeks' gestation in 104 women. In 90 of these women, the 24-h urinary sodium-creatinine ratio was known. Using an effective pressure dose of 10 ng/kg/min as the cutoff level, test characteristics were assessed in both the total population and after subdivision into a sodium restricted (n = 23) and an unrestricted diet group (n = 67).


RESULTS
The incidence of pregnancy-induced hypertension was 13.4%. The number of positive angiotensin sensitivity tests was 7.5%. Test characteristics showed poor sensitivity (22.2%) and high specificity (94.8%); positive and negative predictive values were 40.0% and 88.7%, respectively. None of the sodium-restricted women was angiotensin sensitive. Sodium restriction did not have a significant influence on sensitivity, specificity, and predictive values of the test.


CONCLUSIONS
The angiotensin sensitivity test is not an appropriate screening test to predict hypertensive disorders of pregnancy. No significant effect of dietary sodium restriction was found.
Delemarre
F M
FM
Departments of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands.
Steegers
E A
EA
van Dop
P A
PA
de Jong
P A
PA
D000328:Adult; D000802:Angiotensin Amide; D003404:Creatinine / Q000652:urine; D004039:Diet, Sodium-Restricted; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000178:diet therapy*; D015994:Incidence; D008403:Mass Screening / Q000379:methods* / Q000592:standards*; D010298:Parity; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000178:diet therapy* / Q000378:metabolism; D011263:Pregnancy Trimester, Third; D012680:Sensitivity and Specificity; D012964:Sodium / Q000652:urine; D014662:Vasoconstrictor Agents
D014662:Vasoconstrictor Agents; D000802:Angiotensin Amide; D012964:Sodium; D003404:Creatinine