Quest Study: Looser Criteria Double Primary Aldosteronism Detection
Secaucus – October 19, 2026 -- A broader set of lab criteria identified primary aldosteronism (PA) in 26.2% of 60,449 U.S. patients, twice the 13.0% flagged under the Endocrine Society's 2025 guidelines, according to a Quest Diagnostics (NYSE: DGX) study published in the journal Hypertension.
Study compares 2025 guideline cutoffs with a permissive threshold
Researchers from Quest Diagnostics, Mass General Brigham, Harvard Medical School and the University of Texas Southwestern Medical School analyzed deidentified Quest lab results. The 2025 criteria require plasma renin activity (PRA) of 1 ng/mL/h or lower, aldosterone of at least 7.5 ng/dL and an aldosterone-to-renin ratio (ARR) above 15. The permissive criteria keep the PRA limit, set aldosterone above 5 ng/dL and drop the ARR requirement.
The authors describe the 2025 guidelines as "overly restrictive," with cutoffs that capture only the most advanced cases.