5
Table 1. Groups With High Prevalence of PA
Patient Group Prevalence
Moderate/severe hypertension
Overall, 6.1%
Stage 1 (140–159/mm Hg ) – 2%
Stage 2 (160–179/mm Hg ) – 8%
Stage 3 (>180/110) – 13%
Resistant hypertension
SBP >140/90 mm Hg despite treatment with
three hypertensive medications
17–23%
Hypertensive patients with spontaneous or
diuretic-induced hypokalemia
Specific prevalence figures are not
available, but more frequently
found in this group
Hypertension with adrenal incidentaloma,
defined as an adrenal mass detected
incidentally during imaging performed for
extra-adrenal reasons
Median, 2% (range, 1.1–10%)
Hypertension with obstructive sleep apnea
34% among newly hypertensive
patients referred to a tertiary
referral center and found to have
obstructive sleep apnea
Table 2. Factors That May Lead to False-Positive or False-
Negative ARR Results
Factor
Effect on
Aldosterone
Plasma Levels
Effect
on Renin
Levels
Effect
on ARR
Medications
a
β-Adrenergic blockers
↓ ↓ ↓ ↑ (FP)
Central agonists
(eg, clonidine, α-methyldopa)
↓ ↓ ↓ ↑ (FP)
NSAIDs
↓ ↓ ↓ ↑ (FP)
K+-wasting diuretics
→ ↑ ↑ ↑ ↓ (FN)
K+-sparing diuretics
↑ ↑ ↑ ↓ (FN)
ACE inhibitors
↓ ↑ ↑ ↓ (FN)
ARBs
↓ ↑ ↑ ↓ (FN)
Ca
2
+ blockers (DHPs)
→ ↓ ↑ ↓ (FN)
Renin inhibitors
↓ ↓ ↑ ↑ (FP)
↓ (FN)
