The Aldosterone-to-Renin Ratio for Diagnosing Primary Aldosteronism

Increasingly, evidence suggests that primary aldosteronism is a relatively common — but underdiagnosed — cause of hypertension. This meta-analysis addresses the performance of the aldosterone-to-renin ratio (ARR), which is used commonly to screen patients for primary aldosteronism.

Researchers identified 10 screening studies (4100 patients) in which all patients underwent both ARR and confirmatory testing. Study populations, cutoffs for test positivity, and choice of confirmatory test varied considerably across the included studies. Sensitivity of the ARR for primary aldosteronism ranged from 10% to 100%; specificity ranged from 70% to 100%.