{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T20:45:36Z","timestamp":1769546736841,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study investigated whether patients receiving renin\u2010angiotensin system inhibitors (RASIs) can undergo reliable screening for primary aldosteronism (PA) without discontinuation of therapy. Consecutive patients with hypertension who underwent PA screening at our hospital between 2016 and 2024 while on RASIs were recruited. Plasma aldosterone concentration (PAC) and direct renin concentration (DRC) were measured at three time points: pre\u2010washout, post\u2010washout, and post\u2010captopril\u2010challenge test (CCT). Subsequently, the aldosterone\u2010to\u2010renin ratio (ARR) was calculated, and PAC, DRC, and ARR were compared across time points. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal diagnostic cutpoints. A total of 412 patients on RASIs, with or without calcium\u2010channel blockers (CCBs) or \u03b11\u2010receptor antagonists, were analyzed. Among these, 175 had PA and 237 had essential hypertension (EH). PAC, DRC, and ARR were significantly different between the PA and EH groups across all three time points. Within the PA cohort, PAC (\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    &lt;\u00a00.001) and ARR (\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.016) differed significantly between the pre\u2010washout and post\u2010CCT measurements, whereas DRC did not (\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.456). The optimal pre\u2010washout ARR cutpoint of 2.69 demonstrated a sensitivity of 83.3%, specificity of 87.2%, positive predictive value (PPV) of 82.2%, and negative predictive value (NPV) of 88.1% for diagnosing PA. These findings indicate that pre\u2010washout PAC, DRC, and ARR retain high diagnostic performance for PA in patients treated with RASIs, provided that other agents affecting the renin\u2010angiotensin\u2010aldosterone system are not co\u2010administered.\n                  <\/jats:p>","DOI":"10.1111\/jch.70197","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:51:25Z","timestamp":1767678685000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screening and Diagnosis of Primary Aldosteronism in Patients Using Renin\u2010Angiotensin System Inhibitors"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3335-9553","authenticated-orcid":false,"given":"Qian","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-9805","authenticated-orcid":false,"given":"Hui","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong\u2010Wu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Bao","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiong\u2010Jing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf284"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000002510"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.122.17964"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(17)30319\u20104"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000002216"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.052"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.121.18118"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.119.14063"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae094"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12831"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14142"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20104061"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003480"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2023.04.023"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.121.18761"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010022\u201000948\u20107"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-024-03798-0"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1555572"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017\u201001530"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cdtm.2019.12.009"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab348"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.116.08952"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/m20\u20100065"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2016.72"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr6058"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010021\u201000706\u20101"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(17)30367\u20104"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000002520543"}],"container-title":["The 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