{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:16:59Z","timestamp":1790864219978,"version":"4.1.0"},"reference-count":28,"publisher":"The Endocrine Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Context: Primary aldosteronism (PA) is the most frequent form of secondary hypertension, accounting for up to 5\u201310% of all hypertensive patients, and the diagnosis of PA can present an important challenge for the clinician. After a positive screening test, the diagnosis is confirmed by a suppression test, often an iv saline load test (SLT) or a fludrocortisone suppression test (FST). The FST is considered by many to be the most reliable but is more complex and expensive.<\/jats:p>\n               <jats:p>Objective and Design: Our objective was to compare the specificity of SLT with FST for the diagnosis of PA.<\/jats:p>\n               <jats:p>Patients and Setting: The study included 100 hypertensive patients referred to hypertension units with suspected PA after the screening test.<\/jats:p>\n               <jats:p>Intervention: All patients underwent FST and SLT.<\/jats:p>\n               <jats:p>Main Outcome Measures: We assessed plasma aldosterone concentrations (PAC) before and after FST and SLT.<\/jats:p>\n               <jats:p>Results: After iv SLT, 10.4% of the PA patients were negative and 16.1% of patients with essential hypertension were positive after SLT; that is, a correct diagnosis with SLT was obtained in 88% of patients compared with FST. PAC after SLT and PAC after FST were highly correlated (P &amp;lt; 0.0001). Receiver operator characteristic curve analysis demonstrated that the best cutoff for PAC after SLT was 5 ng\/dl. Patients with aldosterone-producing adenoma displayed a smaller reduction of PAC compared with patients with bilateral adrenal hyperplasia; a PAC after SLT greater than 6 ng\/dl identified all patients eventually diagnosed as having aldosterone-producing adenoma.<\/jats:p>\n               <jats:p>Conclusions: This study demonstrates that the iv SLT is a reasonably good alternative to the more expensive and complex FST for the diagnosis of PA after a positive screening test.<\/jats:p>","DOI":"10.1210\/jc.2006-0078","type":"journal-article","created":{"date-parts":[[2006,5,3]],"date-time":"2006-05-03T01:29:44Z","timestamp":1146619784000},"page":"2618-2623","source":"Crossref","is-referenced-by-count":155,"title":["Comparison of Confirmatory Tests for the Diagnosis of Primary Aldosteronism"],"prefix":"10.1210","volume":"91","author":[{"given":"Paolo","family":"Mulatero","sequence":"first","affiliation":[{"name":"Division of Internal Medicine and Hypertension (P.M., A.M., F.V.), University of Torino, 10133 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Milan","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Hypertension (P.M., A.M., F.V.), University of Torino, 10133 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fallo","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine 3 (F.F.), University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Regolisti","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine (G.R.), Reggio Emilia Hospital, 42100 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pizzolo","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine B (F.P.), University of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Fardella","sequence":"additional","affiliation":[{"name":"Division of Endocrinology (C.F., L.Mo.), P. Universitad Catolica de Chile, 114D Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Mosso","sequence":"additional","affiliation":[{"name":"Division of Endocrinology (C.F., L.Mo.), P. Universitad Catolica de Chile, 114D Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Marafetti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism (L.Ma., F.V., M.M.), University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Veglio","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Hypertension (P.M., A.M., F.V.), University of Torino, 10133 Torino, Italy"},{"name":"Division of Endocrinology and Metabolism (L.Ma., F.V., M.M.), University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Maccario","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism (L.Ma., F.V., M.M.), University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071614092006100_R1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.tem.2005.02.007","article-title":"Diagnosis of primary aldosteronism: from screening to subtype differentiation","volume":"16","author":"Mulatero","year":"2005","journal-title":"Trends Endocrinol Metab"},{"key":"2020071614092006100_R2","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1210\/jc.2003-031337","article-title":"Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents","volume":"89","author":"Mulatero","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614092006100_R3","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jacc.2005.01.015","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism","volume":"45","author":"Milliez","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2020071614092006100_R4","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1161\/01.HYP.0000038478.59760.41","article-title":"Drug effects on aldosterone\/plasma renin activity ratio in primary aldosteronism","volume":"40","author":"Mulatero","year":"2002","journal-title":"Hypertension"},{"key":"2020071614092006100_R5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1161\/01.HYP.0000079505.25750.11","article-title":"Primary aldosteronism and hypertensive disease","volume":"42","author":"Mosso","year":"2003","journal-title":"Hypertension"},{"key":"2020071614092006100_R6","first-page":"865","article-title":"Primary aldosteronism and other forms of mineralocorticoid hypertension","author":"Gordon","year":"1994","journal-title":"In: Swales JD, ed. 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