Screening Renin-Aldosterone Profiles and Long-term Cardiovascular Risk After Primary Aldosteronism Evaluation

Background: Aldosterone-to-renin ratio (ARR) and plasma renin activity (PRA) are measured at the screening stage of primary aldosteronism (PA) evaluation, but their prognostic relevance after confirmatory classification and subsequent treatment remains uncertain. Methods: We linked the seven-hospital Taiwan Primary Aldosteronism Investigation cohort (1991-2023) with nationwide health insurance and mortality data through June 2025. Patients were classified as confirmatory-test-defined essential hypertension (EH), PA without adrenalectomy, or PA with subsequent adrenalectomy. Covariate-adjusted

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