30% of the adult population suffer from hypertension and out of these, 15-20% of hypertensive patients may have Primary Aldosteronism (PA) or Renovascular Hypertension (RVH).
In PA excess, aldosterone levels may be produced due to an adenoma (Conn’s syndrome) or hyperplasia, causing blood pressure elevation. Patients with this condition are at a stronger risk of heart disease and stroke than those with essential hypertension. PA patients also have higher cardiovascular morbidity and mortality than age and sex-matched patients with essential hypertension. RVH is due to the narrowing of one or both of the renal arteries as a result of an atherosclerotic plaque or fibro muscular dysplasia.
According to the Endocrine Society guidelines, both Renin and Aldosterone need to be measured as the Aldosterone to Renin ratio (ARR) is the screening test for PA. An elevated ARR is indicative of the presence of PA. The measurement of Renin can also be used to stratify risk of essential hypertension patients.