Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.
X, L., Z, G., S, H., H, D., W, Z., H, Z., H, W., Y, L., J, B., & W, M. (2026). Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70338
X L, Z G, S H, H D, W Z, H Z, et al. Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.. Journal of clinical hypertension (Greenwich, Conn.). 2026; doi: 10.1111/jch.70338
X L, Z G, S H, et al. Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.[J]. Journal of clinical hypertension (Greenwich, Conn.). 2026. DOI: 10.1111/jch.70338.
@article{x2026,
author = {Liu X and Gu Z and Hao S and Dong H and Zhang W and Zhang H and Wu H and Lou Y and Bian J and Ma W},
title = {Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.},
journal = {Journal of clinical hypertension (Greenwich, Conn.)},
year = {2026},
doi = {10.1111/jch.70338},
note = {PMID: 42578345},
}
TY - JOUR AU - Liu X AU - Gu Z AU - Hao S AU - Dong H AU - Zhang W AU - Zhang H AU - Wu H AU - Lou Y AU - Bian J AU - Ma W TI - Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study. T2 - Journal of clinical hypertension (Greenwich, Conn.) PY - 2026 DO - 10.1111/jch.70338 AN - PMID:42578345 ER -
This retrospective cohort study preliminarily investigated the feasibility of implementing primary aldosteronism (PA) screening without discontinuing dihydropyridine calcium channel blockers (DHP-CCBs). We screened all patients undergoing diagnostic testing for secondary hypertension from January 2017 to May 2022 at authors' center. For inclusion, patients must be on DHP-CCBs monotherapy for hypertension. Aldosterone and renin concentration were measured pre- and post-washout. Confirmatory tests were conducted in patients with positive screen [combination of ARR >2.5 (ng/dL)/(μIU/mL), aldosterone ≥10 ng/dL, and renin ≤8.2 μIU/mL] after washout. The final analysis included a total of 198 patients (median age: 49.5 years and 117 men). Confirmatory tests identified PA in 31 (15.7%) patients. Aldosterone-to-renin ratio (ARR) increased in 158 (79.8%) patients after washout. In 168 patients with a negative pre-washout screen, 22 turned positive after washout, and 14 were diagnosed PA. Consequently, the missed diagnosis rate of PA was 45.2% (14/31) when using standard positive screen criteria before washout of DHP-CCBs monotherapy. Exploratory analysis indicated that a pre-washout ARR cutoff of >1.2 (ng/dL)/(μIU/mL) demonstrated 0.97 sensitivity and 0.75 specificity. In conclusions, caution is warranted when interpretating screening results from patients on DHP-CCBs monotherapy due to the potential risk of missed diagnosis. Preliminary data suggest that ARR ≤1.2 (ng/dL)/(μIU/mL) before washout may serve as a candidate threshold for excluding PA in these patients, though this observation remains a hypothesis-generating finding that requires further investigation.