Hyperaldosteronism Test | Hypertension Blood Test

Primary Aldosteronism Test

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

Test details

Sample type:

Blood

Preparation:

You must schedule an appointment for sample collection at least two hours AFTER you have been awake. Fasting is not required for this test.

Test type: In Person

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$89.00

+ $6.00 Physician Service Fee

Quantity

About the Test

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.

Buy a primary aldosteronism test online with Quest. No doctor's visit required - simply purchase hormone testing and visit a nearby location for sample collection.

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

You must be 18 years of age or older to purchase a test on questhealth.com. This test requires specimen collection at a Quest Diagnostics location. Collection not available in AK, AZ, or HI.

You must schedule an appointment for sample collection at least two hours AFTER you have been awake. Fasting is not required for this test.

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 receive abnormal results, you will receive an alert call from an independent healthcare coordinator to discuss next steps. Independent physicians 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 physician 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.

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). Last reviewed July 22, 2024. Accessed September 3, 2024. https://.my.clevelandclinic.org/health/diseases/21061-conns-syndrome
Centers for Disease Control and Prevention (CDC). Division for Heart Disease and Stroke Prevention. Million Hearts®. Hypertension cascade: hypertension prevalence, treatment, and control estimates among US adults aged 18 years and older applying the criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2017–2020. Last reviewed May 12, 2023. Accessed September 3, 2024. 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
Cobb A, Aeddula NR. Primary hyperaldosteronism. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2024. Last updated December 5, 2023. 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