{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:57:17Z","timestamp":1791255437719,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Current guidelines recommend use of the aldosterone\u2010renin ratio (\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              ) for the case detection of primary aldosteronism followed by confirmatory tests to exclude false\u2010positive results from further diagnostic workup. We investigated the hypothesis that this could be unnecessary in patients with a high\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              value if the quantitative information carried by the\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              is taken into due consideration.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We interrogated 2 large data sets of prospectively collected patients studied with the same predefined protocol, which included the captopril challenge test. We used an unambiguous diagnosis of aldosterone\u2010producing adenoma as reference index. We also assessed whether the post\u2010captopril\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              and plasma aldosterone concentration fall furnished a diagnostic gain over baseline\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              values. We found that the false\u2010positive rate fell exponentially, and, conversely, the specificity increased with rising\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              values. At receiver operating characteristics curves and diagnostic odds ratio analysis, the high baseline\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              values implied very high positive likelihood ratio and diagnostic odds ratio values. The baseline and post\u2010captopril\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              showed similar diagnostic accuracy (area under the receiver operating characteristics curve) in both the exploratory and validation cohorts, indicating lack of diagnostic gain with this confirmatory test (between\u2010area under the curve difference, 0.005; 95%\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n              , \u22120.031 to 0.040;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.7 for comparison, and 0.05; 95%\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n              , \u22120.061 to 0.064;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.051 for comparison, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              These results indicate that the\n              <jats:styled-content style=\"fixed-case\" toggle=\"no\">ARR<\/jats:styled-content>\n              conveys key quantitative information that, if properly used, can simplify the diagnostic workup, resulting in saving of money and resources. This can offer the chance of diagnosis and ensuing adrenalectomy to a larger number of hypertensive patients, ultimately resulting in better control of blood pressure.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.005574","type":"journal-article","created":{"date-parts":[[2017,5,21]],"date-time":"2017-05-21T20:10:19Z","timestamp":1495397419000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Quantitative Value of Aldosterone\u2010Renin Ratio for Detection of Aldosterone\u2010Producing Adenoma: The Aldosterone\u2010Renin Ratio for Primary Aldosteronism (AQUARR) Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Giuseppe","family":"Maiolino","sequence":"first","affiliation":[{"name":"University of Padua","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Rossitto","sequence":"additional","affiliation":[{"name":"University of 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