Ceccato, Filippo and Tizianel, Irene (2025) Role of postural test in differentiating primary aldosteronism from low renin hypertension. [Data Collection]
Collection description
Background: The diagnostic accuracy of screening procedures and confirmatory tests is suboptimal to differentiate primary aldosteronism (PA) among patients with low-renin hypertension (HTN) is challenging. Our aim was to assess the role of postural stimulation test (PST, previously used for PA subtyping) in differentiating PA from low-renin HTN. Patients and methods: Clinical and endocrine data in clinostatic position (CP) and orthostatic position (OP) were evaluated in 190 hypertensive patients: 80 PA and 110 low-renin HTN. Multivariate techniques were computed: Principal Component Analysis (PCA), Partial Least Square-Discriminant Analysis (PLS-DA) and k-means clustering. Results: PST response showed 56/190 patients with suppressed renin levels in CP and OP (54/56 were PA), 56/190 with de-suppression of renin from CP to OP (45/56 were low-renin HTN), and 78/190 with renin measurable in CP and OP. Increased potassium and measurable renin in OP were predictors of low-renin HTN. Cluster analysis distinguished PA from low-renin: Cluster 2 included 104/110 low-renin HTN; Cluster 1 PA patients showed a higher frequency of suppressed renin levels at baseline and during PST (100% in CP and 95% in OP, respectively). Cluster 1 low-renin HTN patients had lower potassium and a higher frequency of suppressed renin levels at diagnosis and during PST, compared to Cluster 2. PLS-DA and PCA confirmed that renin in OP, renin response to PST and presence of hypokalemia were the most relevant parameters for distinguishing PA from low-renin HTN. Conclusion: Renin response during PST can be used to exclude PA among patients with low-renin HTN.
| DOI: |  10.25430/researchdata.cab.unipd.it.00001508 |
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| Keywords: | primary aldosteronism, postural stimulation test; low-renin hypertension; aldosterone; renin. | |||||||||
| Subjects: | Life Sciences > Physiology, Pathophysiology and Endocrinology: Organ physiology, pathophysiology, endocrinology, metabolism, ageing, tumorigenesis, cardiovascular diseases, metabolic syndromes > Comparative physiology and pathophysiology | |||||||||
| Department: | Departments > Dipartimento di Medicina (DIMED) | |||||||||
| Depositing User: | Filippo Ceccato | |||||||||
| Date Deposited: | 10 Mar 2025 07:49 | |||||||||
| Last Modified: | 10 Mar 2025 07:49 | |||||||||
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| Type of data: | Database | |||||||||
| Collection period: |
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| Resource language: | english | |||||||||
| Metadata language: | english | |||||||||
| Publisher: | Research Data Unipd | |||||||||
| Date: | 6 March 2025 | |||||||||
| Copyright holders: | The Author | |||||||||
| URI: | https://researchdata.cab.unipd.it/id/eprint/1508 |
orcid.org/0000-0003-1456-8716
