Is It Possible to Screen for Primary Aldosteronism Effectively in Primary Care?
Authors' conclusion
Screening for PA in primary care with ARR is feasible with modest concordance and comparable sensitivity to secondary care testing. Simple referral criteria and raising awareness among primary care colleagues could ensure appropriate referral to secondary care.
Study context
- Population
- Adults screened for primary aldosteronism (PA) in primary care services in Oxford, UK, 2008–2022455 referred
- Participants
- 2,915 adults
- Exposure
- Primary care aldosterone:renin ratio (ARR) vs secondary care ARR for PA screening
- Outcome
- PA diagnosis and primary care ARR performance
Main finding
As reported in the abstract
Correlation r
0.841
P < 0.001
Primary care ARR
Kappa
0.583
P < 0.001
modest concordance
Primary care ARR
- AUC to predict PA
- 0.81 (95% CI 0.77-0.86)
- Sensitivity (cut-off ≥ 30 pmol/mU)
- 91.7%
Secondary care ARR
92.1%
sensitivity
- Diagnosed with PA
- 107 (3.7% of total population screened)
Observational data: associations, not effects.
Further findings
False positive test result with beta-blocker use
| OR (95% CI) | P value | ||
|---|---|---|---|
| Beta-blockersHigher risk | 3.5 (1.1–12.0) | P = 0.042 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Is It Possible to Screen for Primary Aldosteronism Effectively in Primary Care? Clin Endocrinol (Oxf). Published 7 April 2025. doi:10.
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