[en] INTRODUCTION: Given de high prevalence of primary hyperaldosteronism and excess vascular damage linked to it is important to have a reliable and practical test to confirm the diagnosis. There is no consensus at present about the test of choice for this objective. The literature lacks comparative studies between the tests used in the clinic. HYPOTHESIS AND OBJECTIVES: The present study has focused on the comparative assessment of the values of plasma aldosterone, renin activity and the ratio between both after administration of oral captopril, with the values of plasma aldosterone in the 4th test day fludrocortisone, try to check the validity of the captopril test in the diagnosis of primary aldosteronism confirmation. METHODS: Cross-sectional study with review of data from the medical records of 220 hypertensive patients seen at the Hypertension Unit of the Health Area of Ferrol over 2006-2011. The initial selection criterion was the presence of hypertension and the objectification of aldosterone / plasma renin activity increased, clinical indication for performing captopril test and fludrocortisone test. RESULTS: Using the methodology of ROC curves were obtaind areas under the curve for makers to study after administration of captopril. The values obtaind were 0,58 (IC 95%: 0,50-0,65); 0,59 (IC 95%: 0,52-0,66) and 0,63 (IC 95%: 0,56-0,70) for plasma aldosterone, renin activity and the ratio between them respectively. CONCLUSIONS: The captopril test is inefficient when discriminating between essential hypertensive patients with primary aldosteronism, with little use in clinical practice, discouraging it use in the diagnosis of primary aldosteronism confirmation.

[gl] INTRODUCIÓN: Dada a alta prevalencia do hiperaldosteronismo primario e o exceso do dano vascular ligado ao mesmo, é importante dispoñer dun test fiable e práctico para confirmar o devandito diagnóstico. Non existe un consenso na actualidade acerca do test de elección para dito obxectivo. A literatura carece de estudos comparativos entre os diferentes test empleados na clínica. HIPÓTESE E OBXECTIVOS: O presente estudo orientouse cara a valoración comparativa dos valores da aldosterona plasmática, actividade de renina e o cociente entre ambos tras a administración de captopril oral, cos valores de aldosterona plasmática no 4° día do test de fludrocortisona, intenta comprobar a validez do test de captopril no diagnóstico de confirmación do hiperaldosteronismo primario. MÉTODOS: Estudo transversal, con revisión dos datos das historias clínicas de 220 pacientes hipertensos atendidos na Unidade de Hipertensión da Área sanitaria de Ferrol ao longo de 2006-2011.O criterio de selección inicial foi a presenza de hipertensión arterial e a obxectivación dun cociente aldosterona / actividade de renina plasmática elevado, con indicación clínica de realización do test de captopril e o test de fludrocortisona. RESULTADOS: Utilizando a metodoloxía das curvas ROC, obtivéronse as áreas baixo a curva para os marcadores a estudo posteriores á administración de captopril. Os valores obtidos foron 0,58 (IC 95%: 0,50-0,65); 0,59 (IC 95%: 0,52-0,66) e 0,63 (IC 95%: 0,56-0,70) para aldosterona plasmática, actividade de renina e o cociente entre ambos respectivamente. CONCLUSIONS: O test de captopril é pouco eficiente á hora de discriminar entre pacientes hipertensos esenciais e con hiperaldosteronismo primario, sendo pouco útil na práctica clínica, desaconsellándose o seu uso no diagnóstico de confirmación do hiperaldosteronismo primario.