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

July 7, 2026 updated by: Peking Union Medical College Hospital
Primary aldosteronism (PA) is the most common cause of secondary hypertension. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is more accurate than the traditional radioimmunoassay method in measuring aldosterone. This study aims to establish a more precise diagnostic cutoff value for the captopril stimulation test (CCT) by measuring aldosterone levels using LC-MS/MS. The investigators will combine the detection results of CCT from healthy volunteers and suspected PA patients, etc., to determine the new CCT cutoff value. The investigators expect to improve the diagnostic accuracy of PA, helping clinicians identify this curable cause of hypertension earlier and more accurately, and achieving precise treatment.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

800

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Beijing Municipality
      • Beijing, Beijing Municipality, China, 456350

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

1）Healthy Controls to establish physiological suppression limits.2) Patients with suspected PA undergo captopril inhibition test to determine the cut-off point.

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients suspected of having primary aldosteronism
Diagnostic test: Captopril inhibition test(CCT)
The subjects are required to stop using any drugs that affect the RAAS system in advance. At 08:00 on the test day, they are to remain seated and collect baseline blood samples. Then, they are to take 25mg of captopril orally. After taking the medicine, they are to remain seated and fast for 2 hours, and then collect blood samples again at 10:00. The blood samples collected at these two time points will undergo mass spectrometry analysis to detect plasma aldosterone and renin activity, and 24-hour urine samples will be collected to measure 24-hour urine sodium and 24-hour urine potassium.
normal sujects
Healthy volunteers with normal blood pressure, normal blood potassium levels, and no adrenal nodules. These individuals were used to establish the normal physiological range (lower limit) of aldosterone suppression after the test.
Diagnostic test: Captopril inhibition test(CCT)
The subjects are required to stop using any drugs that affect the RAAS system in advance. At 08:00 on the test day, they are to remain seated and collect baseline blood samples. Then, they are to take 25mg of captopril orally. After taking the medicine, they are to remain seated and fast for 2 hours, and then collect blood samples again at 10:00. The blood samples collected at these two time points will undergo mass spectrometry analysis to detect plasma aldosterone and renin activity, and 24-hour urine samples will be collected to measure 24-hour urine sodium and 24-hour urine potassium.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Plasma Aldosterone Concentration (PAC) by LC-MS/MS before and after captopril inhibition test
Time Frame: Two weeks after completing the captopril inhibition test
Two weeks after completing the captopril inhibition test
Plasma Renin activity(PRA) by LC-MS/MS before and after captopril inhibition test
Time Frame: Two weeks after completing the captopril inhibition test
Two weeks after completing the captopril inhibition test
Aldosterone-renin ratio（ARR）by LC-MS/MS before and after captopril inhibition test
Time Frame: Two weeks after completing the captopril inhibition test
Two weeks after completing the captopril inhibition test

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Peking Union Medical College Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 28, 2025

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

August 1, 2026

Study Registration Dates

First Submitted

June 3, 2026

First Submitted That Met QC Criteria

July 7, 2026

First Posted (Actual)

July 9, 2026

Study Record Updates

Last Update Posted (Actual)

July 9, 2026

Last Update Submitted That Met QC Criteria

July 7, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • pumch-06086-11

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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