Table 6 Confirmatory tests of aldosterone excess

From: Chapter 12. Secondary hypertension

  Methods Criteria for positive results Adverse effects
Captopril challenge test Oral administration of captopril at 50 mg (crushed) ARR (60 or 90 min)200 (or350)a Hypotension
Furosemide-upright test i.v. injection of furosemide at 40 mg and upright posture for 2 h PRAmax1.0 ng ml−1 h−1 (or2.0) Orthostatic hypotension, a decrease in the serum K level
Saline infusion test i.v. drip infusion of saline at 2 l per 4 h PAC (4 h)85 pg ml−1 (50100) Rise in blood pressure, not indicated in patients with impaired heart/kidney function, a decrease in the serum K level
  1. Abbreviations: PAC, plasma aldosterone concentration; PRA, plasma renin activity.
  2. aARR is calculated with PAC in the unit of pg ml−1.