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Background Primary aldosteronism (PA), a more frequent form of secondary hypertension than previously thought, is commonly produced by either an aldosterone-producing adenoma or by adrenal hyperplasia. PA is characterized by elevated plasma levels of aldosterone and suppressed renin secretion. Calculation of the aldosterone-to-renin ratio (ARR) was introduced 30 years ago as a convenient screening test for the diagnosis of PA due to the unique and characteristic profile of aldosterone and renin levels observed in this disorder. The relationship between the ARR and aldosterone values can be used to easily depict subgroup differentiation of primary and secondary hyperand hypoaldosteronism as well as normal subjects (Fig. 1; McKenna et al., 1991). By assessing the levels of plasma aldosterone in relation to ARR, a variety of disorders of the renin-angiotensin-aldosterone axis can be described. Identifying hypertensive patients with PA is crucial for optimizing their treatment. Various medications used to treat hypertension are known to alter levels of aldosterone and renin, thus affecting the ARR. As withdrawing all medication before screening is often unrealistic, we aimed to determine the degree of interference of some commonly used agents on the ARR using assays on the automated IDS-iSYS platform (Boldon, UK).

endocrine abstracts

ARR screening using IDS-iSYS aldosterone and direct renin: effects of medication in essential and renovascular hypertension, Cushing's syndrome and primary aldosteronism