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Horm Metab Res 2017; 49(11): 831-837
DOI: 10.1055/s-0043-119220
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Aldosterone to Renin Ratio as a Screening Instrument for Primary Aldosteronism in a Middle-Aged Population with Atrial Fibrillation

Georgios Mourtzinis
1   Department of Medicine and Emergency, Sahlgrenska University Hospital, Mölndal, Sweden
2   Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sahlgrenska University Hospital, Göteborg, Sweden
,
Ahmad Ebrahimi
1   Department of Medicine and Emergency, Sahlgrenska University Hospital, Mölndal, Sweden
,
Helena Gustafsson
3   Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
,
Gudmundur Johannsson
4   Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Göteborg and Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
,
Karin Manhem
2   Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sahlgrenska University Hospital, Göteborg, Sweden
› Author Affiliations
Further Information

Publication History

received 01 March 2017

accepted 31 August 2017

Publication Date:
21 September 2017 (online)

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Abstract

Atrial fibrillation seems to be overrepresented among patients with primary aldosteronism. The aim of this study was to determine the usefulness of aldosterone to renin ratio as a screening instrument for primary aldosteronism in an atrial fibrillation population with relatively low cardiovascular risk profile. A total of 149 patients <65 years and with history of AF were screened for primary aldosteronism using aldosterone to renin ratio. Pathologically increased aldosterone to renin ratio (>65 pmol/mIU) was found in 15 participants (10.1%). Further investigation of the positive screened participants and confirmatory saline infusion test resulted in a diagnosis of primary aldosteronism in four individuals out of 149 (2.6%). Three out of the four individuals with primary aldosteronism had previously been diagnosed with hypertension, but only one out of the four had uncontrolled blood pressure, that is, >140/90 mmHg. All participants had normal potassium levels. Individuals with increased aldosterone to renin ratio had significantly higher mean systolic and diastolic blood pressure in comparison to participants with normal aldosterone to renin ratio (136 vs. 126 mmHg, p=0.02 and 84 vs. 78 mmHg, p=0.02). These findings suggest that assessment of aldosterone to renin ratio can be useful for identification of underlying primary aldosteronism in patients with diagnosed atrial fibrillation and hypertension in spite of well controlled blood pressure and normokalemia.

Key words

atrial fibrillation - hypertension - aldosteronism - aldosterone to renin ratio

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