THE USEFULNESS OF THE CAPTOPRIL TEST AS A SIMULTANEOUS SCREENING FOR PRIMARY ALDOSTERONISM AND RENOVASCULAR HYPERTENSION

被引:17
作者
IWAOKA, T
UMEDA, T
NAOMI, S
INOUE, J
SASAKI, M
YAMAUCHI, J
SATO, T
机构
[1] Kumamoto University Medical School, Honjo, Kumamoto
[2] Kumamoto University Medical School, Kumamoto
关键词
CAPTOPRIL TEST; PRIMARY ALDOSTERONISM; RENOVASCULAR HYPERTENSION; RENIN; ALDOSTERONE; DISCRIMINANT ANALYSIS;
D O I
10.1093/ajh/6.11.899
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
The usefulness of the captopril test as a simultaneous screening method for primary aldosteronism (PA) and renovascular hypertension (RVH) was evaluated in 111 patients with essential hypertension, and in 79 patients with secondary hypertension, which included 16 patients with PA and 18 with RVH. Plasma renin activity (PRA, ng/mL/h) and plasma aldosterone concentration (PAC, ng/dL) were determined before and 90 min after administration of 50 mg of captopril in the supine position on a normal NaCl diet. A cutoff point or a discriminant function in the screening was determined by discriminant analysis. A quadratic discriminant function of PRA and PAC after the captopril test identified patients with PA with a false negative rate of 6.3% (1/16), and a false positive rate of 0.6% (1/174) which was significantly lower than that of 3.4% at the basal state (P < .05). In the screening for RVH, the criterion of a postcaptopril PRA of greater than 10.6 ng/mL/h had a false negative rate of 5.6% (1/18) and a false positive rate of 15.1% (26/172). This false positive rate was also significantly lower than that using a criterion for precaptopril PRA of 2.21 ng/mL/h (P < .05). Accordingly, the captopril test was a useful method in the simultaneous screening for PA and RVH, and it may be particularly applicable in specialized hypertension clinics.
引用
收藏
页码:899 / 906
页数:8
相关论文
共 25 条
[1]  
Working group on renovascular hypertension: Detection, evaluation, and treatment of renovascular hypertension, Final Report. Arch Intern Med, 147, pp. 820-829, (1987)
[2]  
Grim C.E., Luft F.C., Weinberger M.H., Sensitivity and specificity of screening test for renal vascular hypertension, Ann Intern Med, 91, pp. 617-622, (1979)
[3]  
Carey R.M., Douglas J.G., Schweikert J.R., The syndrome of essential hypertension with suppressed plasma renin activity: Normalization of blood pressure with spironolactone, Arch Intern Med, 130, pp. 849-854, (1972)
[4]  
Weinberger M., Grim C.E., Hollifield J.W., Primary aldosteronism. Diagnosis, localization, and treatment, Ann Intern Med, 90, pp. 386-395, (1979)
[5]  
Bravo E.L., Tarazi R.C., Dustan H.P., The changing clinical spectrum of primary aldosteronism, Am J Med, 74, pp. 641-651, (1983)
[6]  
Johnston C.L., Millar J.A., Casley D.J., Hormonal responses to angiotensin blockade, Circ Res, 46, pp. 1.128-1.134, (1980)
[7]  
Muller F.B., Sealey J.E., Case D.B., The captopril test for identifying renovascular disease in hypertensive patients, Am J Med, 80, pp. 633-644, (1986)
[8]  
Derkx F., Tan-Tjiong H.L., Wenting G.J., Captopril test for diagnosis of renal artery stenosis in renovascular hypertension, Raven Press, pp. 295-304, (1987)
[9]  
Frederickson E.D., Wilcox C.S., Bucci C.M., A prospective evaluation of a simplified captopril test for the detection of renovascular hypertension, Arch Intern Med, 150, pp. 569-572, (1990)
[10]  
Gosse P., Dupas J.Y., Reynaud P., Captopril test in the detection of renovascular hypertension in a population with low prevalence of the disease. A prospective study, Am J Hypertens, 2, pp. 191-193, (1989)