Study on the Application of Liquid Chromatography-Tandem Mass Spectrometry for the Determination of Aldosterone and Renin Activity in the Diagnosis of Primary Aldosteronism by Captopril Test

Normal Control Group

Inclusion criteria

• Age 18-70 years old
• BMI: 18.5-23.9kg/m²
• Gender not restricted
• Blood pressure: 100-120/60-80mmHg
• No history of hypertension
• No abnormal nodules found in adrenal CT
• Previous blood potassium and electrocardiogram were all within normal ranges
• No history of liver or kidney dysfunction, malignant tumors, metabolic diseases or cardiovascular diseases
• No medication used

Exclusion criteria

• Those with a family history of hypertension or with clinical manifestations of secondary hypertension
• Those who have been taking drugs that may affect the RAAS system for a long time (such as contraceptives, steroids, etc.)
• Those with cardiac dysfunction or severe arrhythmia and unable to tolerate the test

Patients with suspected primary aldosteronism

Inclusion criteria

• Patients with suspected primary aldosteronism in the outpatient setting
• Willing to undergo 4-week spironolactone treatment and cooperate with follow-up

Exclusion criteria

• Patients who did not complete the captopril suppression test
• Patients with Cushing's syndrome or other endocrine tumors
• Patients allergic to spironolactone or with contraindications for its use (such as severe hyperkalemia, eGFR < 30)
• History of liver or kidney dysfunction
• Coexisting severe cardiovascular or cerebrovascular diseases
• History of malignant tumors
• Other types of endocrine hypertension (hyperthyroidism, pheochromocytoma, Cushing's syndrome, etc.)
• Renal artery stenosis
• Hypokalemia caused by other factors (renal tubular acidosis, Bartter syndrome, Gitelman syndrome, etc.)
• Diabetes with HbA1c > 7.0% or currently using or having used insulin or SGLT2 inhibitor drugs
• Taking special medications such as glucocorticoids, immunosuppressants, oral contraceptives, etc