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Primary Aldosteronism Test

$89.00

+ $6.00 Physician Service Fee

HSA/FSA Accepted

This blood test looks at plasma renin activity to screen for primary aldosteronism (PA), which can be a contributing factor for hypertension. PA is a disease in which the adrenal gland produces too much aldosterone. Too much aldosterone may contribute to uncontrolled high blood pressure (hypertension). Reflex testing for aldosterone is only performed if plasma renin activity level shows that the enzyme, renin, is out of range. Read more

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This test is used to find out if you may have primary aldosteronism (PA), which can be a contributing factor for hypertension. According to the Centers for Disease Control and Prevention, about 120 million people in the US have hypertension. PA is underrecognized in typical aldosterone renin ratio screenings, but when plasma renin activity (PRA) is used for screening, studies have shown that 30% of hypertensive patients in the US may have PA, making it the most common cause of secondary hypertension.^4,5

All the following information is important to discuss with your healthcare provider.

No doctor’s visit needed. Buy this primary aldosteronism test, visit a nearby Quest location, and get fast results.

Sample type: Blood
Test type: In Person
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Preparation: You must schedule an appointment for sample collection at least two hours AFTER you have been awake.

This test may be right for you if:

You have a strong personal or family history of hypertension or first degree relative with primary aldosteronism
You were recently diagnosed with hypertension
You have hypertension that is unresponsive to treatment, especially to standard blood pressure medications
You have severe or resistant hypertension including:
- Blood pressure above 150/100 mm Hg on three different measurements obtained on different days
- Blood pressure above 140/90 mm Hg and does not improve despite combining three conventional antihypertensive drugs
- Blood pressure below 140/90 mm Hg but you are taking four or more blood pressure medications
You have hypertension and low potassium
You have hypertension and adrenal gland tumor
You have hypertension and sleep apnea
You have Stage 2 hypertension

This test may not be right for you if:

Your hypertension is being controlled by medication
You have been diagnosed with Cushing’s syndrome, Addison’s disease, or have cirrhosis of the liver

This primary aldosteronism test measures:

Renin is an enzyme made by your kidneys that acts as a hormone to help control your blood pressure. Renin is usually released when your potassium increases, or your blood pressure or sodium decreases. It helps control aldosterone production as well. Plasma renin activity measures the activity level of the renin to see if it is working properly.

If plasma renin activity is out of range, aldosterone will also be tested.

Aldosterone is a hormone made by your adrenal glands that controls blood pressure by balancing sodium and potassium levels and how much water stays in the bloodstream. Higher levels of aldosterone can cause the kidney to take in extra sodium and get rid of more potassium, leading to increased sodium levels, more water in the blood, and increased blood volume, which in turn raises blood pressure.

Renin and aldosterone levels usually increase and decrease simultaneously and are normally highest in the morning. They change throughout the day and certain things such as body position, medications, and stress levels can affect how high or low they may get.

Signs and symptoms of primary aldosteronism may include those listed below. If you have any of these signs and symptoms, please discuss them with your healthcare provider.

Uncontrolled hypertension
Low potassium levels
Excessive thirst
Fatigue
Muscle cramping or weakness
Tingling/numbness
Constipation
Headaches
Racing heartbeat

Purchaser: You must be 18 years of age or older to purchase a test on questhealth.com.

Patient: This test can be performed on patients between 18 and 100 years old.

Sample collection: This test requires sample collection at a Quest Diagnostics location. Collection is not available in AZ or HI.

You must schedule an appointment for sample collection at least two hours AFTER you have been awake.

After you provide your specimen, it generally takes five business days to process and release your test results. However, processing times may vary. Your test results will be available in a clear and easy-to-read report. If you have or create a MyQuest® account, you may be able to review your new results there with your other Quest results. If you receive abnormal results, you will receive an alert call from an independent healthcare coordinator to discuss next steps. Independent healthcare providers are available to discuss questions or concerns you may have regarding your results.

If your plasma renin activity level is abnormal, the lab will perform an additional test, aldosterone, on the sample you have already provided at no extra cost to you. This additional testing can provide additional diagnostic information to help with care.

How it works

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Book a visit to one of 2000+ Quest locations.

Visit Quest for sample collection

Complete your test sample collection during your scheduled appointment.

Get fast results

Access results online as soon as they’re available. You will be emailed when they are ready. Discuss your results with an independent healthcare provider at no extra cost. Treatment options may be available.

FAQs

What are primary aldosteronism and hypertension, and how are they related?

Primary aldosteronism is a disease in which the adrenal gland produces too much aldosterone. Hypertension, or high blood pressure, is when the pressure in your blood vessels is too high. Too much aldosterone can raise blood pressure to the point that it is uncontrolled by medication.

What are enzymes?

An enzyme is a protein that helps to start, or speed up, a reaction in the body.

Can I use my FSA or HSA funds to purchase tests on questhealth.com?

You may be able to use your FSA or HSA funds to purchase lab tests at questhealth.com. Please review your FSA/HSA plan or check with a tax professional to confirm specific requirements for individual eligibility.

Are tests purchased from questhealth.com covered by my health insurance?

Tests purchased on questhealth.com are intended for individuals paying directly—we do not bill insurance, and purchases cannot be submitted for insurance reimbursement.

If your doctor ordered a lab test for you and you are looking to book an appointment for sample collection, you can schedule an appointment here https://appointment.questdiagnostics.com/as-home.

For other questions related to a lab test your doctor ordered for you, including billing and results, you can visit the main Quest Diagnostics site here https://www.questdiagnostics.com.

Our references

Vaidya, A., Mulatero, P., Baudrand, R., & Adler, G. K. (2018). The expanding spectrum of primary aldosteronism: implications for diagnosis, pathogenesis, and treatment, Endocrine Reviews, 39(6), 1057-1088.

Cleveland Clinic. Primary aldosteronism (Conn’s syndrome). Accessed September 3, 2024. https://my.clevelandclinic.org/health/diseases/21061-conns-syndrome

Million Hearts®. Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults. Accessed March 24, 2026. https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html

Marcelli M, Caixia B, Funder JW, McPhaul MJ. Comparing ARR versus suppressed PRA as screening tests for primary aldosteronism. Hypertension. 2024. doi:10.1161/ HYPERTENSIONAHA.124.22884

Funder JW, Carey RM, Fardella C, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(9):3266–3281. doi: 10.1210/jc.2008-0104

Hung A, Ahmed S, Gupta A, et al. Performance of the aldosterone to renin ratio as a screening test for primary aldosteronism. J Clin Endocrinol Metab. 2021;106(8):2423–2435. doi:10.1210/ clinem/dgab348

NIH National Library of Medicine National Center of Biotechnology Information. Primary Hyperaldosteronism. Accessed September 3, 2024. https://www.ncbi.nlm.nih.gov/books/NBK539779/

Dogra P, Bancos I, Young WF Jr. Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management. Mayo Clin Proc. 2023 Aug;98(8):1207-1215. doi: 10.1016/j.mayocp.2023.04.023. PMID: 37536806.

Young Jr., W. F. (2019). Diagnosis and treatment of primary aldosteronism: practical clinical perspectives. The Journal of Internal Medicine, 285(2), 126-148.

WebMD. What is a Renin Test?. Accessed October 15, 2024. https://www.webmd.com/hypertension-high-blood-pressure/renin-test

MedlinePlus. Renin Test. Accessed October 15, 2024. https://medlineplus.gov/lab-tests/renin-test/

Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance.

Primary Aldosteronism Test