ANGIOTENSIN SENSITIVITY TEST REVISITED

Abstract

Objective: To determinethe validity of a single angiotensin sensitivity test as predictor of pregnancy-inducedhypertension with special reference to the dietary sodium intake at the timeof testing.Methods: The angiotensin sensitivitytest was successfully performed at 32 weeks' gestation in 104 women.In 90 of these women, the 24-h urinary sodium–creatinine ratio was known.Using an effective pressure dose of 10 ng/kg/min as the cutoff level, testcharacteristics were assessed in both the total population and after subdivisioninto a sodium restricted (n = 23) and anunrestricted diet group (n = 67).Results: The incidence of pregnancy-inducedhypertension was 13.4%. The number of positive angiotensin sensitivity testswas 7.5%. Test characteristics showed poor sensitivity (22.2%) and high specificity(94.8%); positive and negative predictive values were 40.0% and 88.7%, respectively.None of the sodium-restricted women was angiotensin sensitive. Sodium restrictiondid not have a significant influence on sensitivity, specificity, and predictivevalues of the test.Conclusion: The angiotensin sensitivitytest is not an appropriate screening test to predict hypertensive disordersof pregnancy. No significant effect of dietary sodium restriction was found.