{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:25:33Z","timestamp":1790612733367,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005890","name":"Hudson Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["101863"],"award-info":[{"award-number":["101863"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Current Endocrine Society Clinical Practice Guidelines use a specific aldosterone\/renin ratio (ARR) threshold to screen for primary aldosteronism (a treatable disease causing up to 15% of hypertension in primary care) in all patients. We sought to characterize demographic variations in the ARR, hypothesizing a need for age\u2010 and sex\u2010specific reference ranges to improve the accuracy of the test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cross\u2010sectional analysis of ARR measurements at a single tertiary hospital from December 2016 to June 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 442 patients with clinically indicated ARR were included, after excluding those who were on spironolactone or the oral contraceptive pill, were pregnant or had an existing adrenal condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Aldosterone, renin and the ARR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among those aged 20\u201039\u00a0years (n\u00a0=\u00a074), females had significantly higher median aldosterone (369 vs 244\u00a0pmol\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.028), lower median renin (17.0 vs 27.6 mIU\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.034) and higher median ARR (20.7 vs 10.3 (pmol\/L)\/(mIU\/L), <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001) than males, despite having lower systolic (135 vs 145\u00a0mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.021) and diastolic (89 vs 96.5\u00a0mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.007) blood pressure. The\u00a0\u2265\u00a060\u2010year age group (n\u00a0=\u00a0157) also had significant sex differences in the ARR. With increasing age (20\u201039 vs\u00a0\u2265\u00a060\u00a0years), there was a significant fall in plasma aldosterone in females (369\u00a0pmol\/L vs 264\u00a0pmol\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005), with no change observed in males.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For those 20\u201039\u00a0years old, aldosterone and the ARR are significantly higher in females despite a lower systolic and diastolic BP, highlighting the potential for false\u2010positive results. Our findings indicate the need for prospective studies with a control population to define age\u2010 and sex\u2010specific ARR reference ranges.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14199","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T11:29:40Z","timestamp":1587295780000},"page":"221-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Age\u2010 and sex\u2010specific reference ranges are needed for the aldosterone\/renin ratio"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5868-3962","authenticated-orcid":false,"given":"Pravik","family":"Solanki","sequence":"first","affiliation":[{"name":"Department of Endocrinology Monash Health Clayton Vic. Australia"},{"name":"Department of Medicine Monash University Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0295-4575","authenticated-orcid":false,"given":"Stella May","family":"Gwini","sequence":"additional","affiliation":[{"name":"Barwon Health University Hospital Geelong Geelong Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1235-9913","authenticated-orcid":false,"given":"James C. G.","family":"Doery","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay Weng","family":"Choy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health Clayton Vic. Australia"},{"name":"Hudson Institute of Medical Research Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0450-5375","authenticated-orcid":false,"given":"Morag J.","family":"Young","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0948-2072","authenticated-orcid":false,"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health Clayton Vic. Australia"},{"name":"Hudson Institute of Medical Research Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":false,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health Clayton Vic. Australia"},{"name":"Department of Medicine Monash University Clayton Vic. Australia"},{"name":"Hudson Institute of Medical Research Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2007-0030"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1472"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2011.09.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30319-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00026.2015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00139"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248326"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2013.05.003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004563215603401"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2011.165662"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7176.2009.00084.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247545"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456328602300108"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-032179"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2015.21"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000258554.87444.91"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2014.129"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000076"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-2918"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2018.04.016"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2017.05.002"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-8206.2010.00854.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-1355"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.gme.0000235369.24479.dd"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8647026"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.5603\/EP.2013.0011"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.14199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.14199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T23:22:42Z","timestamp":1693956162000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,4]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/cen.14199"],"URL":"https:\/\/doi.org\/10.1111\/cen.14199","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,4]]},"assertion":[{"value":"2020-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}