Healthier World with Quest Diagnostics

39 - Instant insights: How to screen for primary aldosteronism (updated guidelines) (9 min)

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In this special episode of Healthier World designed to give you Instant Insights, we take a look at primary aldosteronism (PA)- an often underdiagnosed, yet prevalent cause of hypertension. In this episode, we challenge traditional screening methods and introduce a streamlined diagnostic approach. By recognizing the signs of Primary Aldosteronism earlier, providers can improve patient outcomes and avoid increased risk for cardiovascular and metabolic conditions associated with untreated PA.

This episode will

  • Explain the mechanisms underlying PA and how they disrupt the normal renin-aldosterone feedback system (1:50)
  • Highlight the limitations of historic methodology, and describe updated guidance on PA evaluation (3:10)
  • Walk through an example comparing the ARR with the suppressed renin approach for assessing PA (5:50)
  • Explain the cardiometabolic consequences of untreated PA and the importance of proactive screening, particularly in patients with chronic kidney disease (6:50)

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    The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.

    Date: 6/2025

    Speaker(s): Maeson Latsko, PhD

    Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC; Akhil Singh; Smruti Sheth, Marco Marcelli, MD

    Additional Resources:

    https://www.questdiagnostics.com/healthcare-professionals/about-our-tests/endocrine-disorders/primary-aldosteronism

    Ordering information:

    Plasma Renin Activity with Reflex to Aldosterone | Test Detail | Quest Diagnostics

     

    References:

    Adler GK, Stowasser M, Correa RR, et al. Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2025;110(9):2453-2495. doi:10.1210/clinem/dgaf284

     

    Writing Committee Members*, Jones DW, Ferdinand KC, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Hypertension. 2025;82(10):e212-e316. doi:10.1161/HYP.0000000000000249

     

    Marcelli M, Bi C, Funder JW, McPhaul MJ. Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism. Hypertension. 2024;81(10):2072-2081. doi:10.1161/HYPERTENSIONAHA.124.22884

     

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

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