原发性醛固酮增多症（PA）是继发性高血压的已知原因。我们长期以来在PA患者中进行了简单的站立试验。另一方面，关于简单站立试验在PA中的实用性的报道很少。本研究是一项单中心的回顾性观察研究。共纳入了173名因高血压或肾上腺肿瘤入院的患者。符合排除标准的80名患者被排除在外，纳入了31名非PA患者、26名单侧PA患者和36名双侧PA患者。在120分钟的站立或坐立后进行了简单的站立试验，并计算了醛固酮/肾素比（ARR）和血浆醛固酮浓度的百分比增加（% PAC的增加）。在单侧PA（1143（528-2200））和双侧PA（521（374-765））受试对象的简单站立试验中，平均ARR显著高于非PA受试对象（152（102-240））（p < 0.0001，p = 0.0013，分别）。单侧PA受试对象的PAC增加百分比在站立负荷后显著低于非PA受试对象（110（96-140））（p = 0.0003），而非PA与双侧PA受试对象之间无差异（p = 0.99）。本研究中用于PA诊断的简单站立试验的截断值为364（AUC = 0.948，敏感性 = 83.8%，特异性 = 93.5%，假阳性率 = 3.7%，假阴性率 = 25.6%，p < 0.001），它的诊断性能不逊于卡托普利负荷试验。简单站立试验对PA的诊断性能不逊于卡托普利负荷试验。单侧PA患者的PAC百分比增加显著低于双侧PA患者。这些结果显示了简单站立试验的实用性，可以与一般PA筛查测试同时进行。© 2023. Springer Nature Limited.

Primary aldosteronism (PA) is a well-known cause of secondary hypertension. We have long performed the simple standing test in patients with PA. On the other hand, there are few reports on the usefulness of the simple standing test in PA. This study is a single-center, retrospective, observational study. A total of 173 patients with hypertension or adrenal tumor admitted to Kawasaki Medical School were included. Eighty patients who met the exclusion criteria were excluded, and 31 patients without PA (non-PA), 26 patients with unilateral PA, and 36 patients with bilateral PA were included in the study. The simple standing test was performed after 120 min of standing or sitting followed, and the aldosterone/renin ratio (ARR) and percentage of increase plasma aldosterone concentration (%increase of PAC) was calculated. The mean ARR in the simple standing test in unilateral PA (1143 (528-2200)) and bilateral PA subjects (521 (374-765)) were significantly higher compared to non-PA subjects (152 (102-240)) (p < 0.0001, p = 0.0013, respectively). The percentage increase of PAC after standing loading was significantly lower in unilateral PA subjects (110 (96-140)) compared to non-PA subjects (187 (155-244)) (p = 0.0003), with no difference between non-PA and bilateral PA subjects (p = 0.99). The cutoff value of the ARR in the simple standing test for diagnosis of PA in this study was 364 (AUC = 0.948, sensitivity = 83.8%, specificity = 93.5%, false positive rate = 3.7%, false negative rate = 25.6%, p < 0.001), which was not inferior to the diagnostic performance of the captopril loading test. The diagnostic performance of the simple standing test for PA was not inferior to that of the captopril loading test. The percentage increase of PAC in unilateral PA subjects was significantly lower compared to bilateral PA subjects. These results demonstrate the usefulness of the simple standing test, which can be performed simultaneously with general screening tests of PA.© 2023. Springer Nature Limited.