Table 3.

Drugs and conditions that affect aldosterone, renin, and aldosterone:renin ratio

Adapted from Rossi GP. Primary Aldosteronism: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019;74:2799–811 [9]

Factor	PAC	Renin	ARR	FP rate	FN rate
Medications
β-Blockers	↓	↓ ↓	↑	↑ ↑	↓
Central α-2 adrenergic receptor agonistsa	↓	↓ ↓	↑	↑	↓
NSAIDs	↓	↓ ↓	↑	↑	↓
K+-losing diuretic agents	↑	↑ ↑	↓	↓	↑
K+-sparing diuretic agents	↑	↑ ↑	↓	↓	↑
ACE inhibitors	↓	↑ ↑	↓	↓	↑
ARBs	↓	↑ ↑	↓	↓	↑
Long-acting CCBs	→↓	→	↓	→↓	→↑
Potassium status
Hypokalemia	↓	→↑	↓	↓	↑
Potassium loading	↑	→↑	↑	↑	↓
Sodium status
Sodium depletion	↑	↑ ↑	↓	↓	↑
Sodium loading	↓	↓ ↓	↑	↑	↓
Other conditions
Aging	↓	↓	↑	↑
Renal impairment	→	↓	↑	↑	↓
Pregnancy	↑	↑ ↑	↓	↓	↓
Renovascular	↑	↑ ↑	↓	↓	↑
Malignant	↑	↑ ↑	↓	↓	↑

PAC plasma aldosterone concentration, ARR aldosterone: renin ratio, ACE angiotensin-converting enzyme, ARBs angiotensin II type 1 receptor blockers, NSAIDs non-steroidal anti-inflammatory drugs, CCBs calcium-channel blockers, FP false positive, FN false negative

^aExcept for moxonidine, which has been associated with no significant change in the ARR values limitedly to healthy volunteers in the study of Ahmed et al. [20]