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Aldosterone & renin: the hormones behind blood pressure
Your kidneys and adrenal glands use hormones to manage salt, water and blood pressure. Measuring aldosterone and renin together can help clinicians look for one hormone-driven cause of high blood pressure.
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Text description of this 3D model
A red bean-shaped kidney with a small amber, pyramid-shaped adrenal gland on top, connected by a short artery to a vertical blood vessel on the left. In the renin step, teal dots leave the kidney into the bloodstream. In the aldosterone step, gold diamond shapes travel from the adrenal gland through the bloodstream back to the kidney. In the imbalance view, the adrenal gland glows and sends many gold signals while almost no teal renin appears.
The kidney (red) and the adrenal gland that sits on top of it (amber) send hormone signals through the bloodstream to help keep blood pressure and salt balance steady.
When the kidneys sense lower blood pressure or less salt, they release renin (teal). Renin starts a chain reaction that makes angiotensin II, which narrows blood vessels and signals the adrenal glands.
The adrenal glands release aldosterone (gold). It tells the kidneys to hold on to sodium and water and let go of potassium, which raises blood volume and blood pressure.
In primary aldosteronism, the adrenal glands make too much aldosterone on their own, and renin is usually suppressed. That makes the aldosterone-to-renin ratio high. This is an illustration of the pattern, not a diagnosis.
What to know
- Primary aldosteronism is one of the most common identifiable causes of high blood pressure, but it often goes unrecognized.
- The Endocrine Society's 2025 guideline recommends screening people with high blood pressure for primary aldosteronism, using the aldosterone-to-renin ratio.
- Many blood-pressure medicines, potassium level, salt intake, posture and time of day can affect results. Never stop or change a medicine to prepare for this test unless your clinician tells you to.
- An abnormal screening result usually leads to confirmatory testing, often with a specialist. The ratio alone doesn't diagnose anything.
What this test can do
- Screen for a hormone-driven pattern behind high blood pressure
- Help your clinician decide whether more testing is needed
What it can't do on its own
- Diagnose primary aldosteronism by itself
- Be read correctly without knowing your medicines and potassium level
- Replace blood-pressure monitoring
Questions to bring to your clinician
- “Should I be screened for primary aldosteronism?”
- “Do any of my medicines affect this test?”
- “How should I prepare, and what time of day should the sample be drawn?”
Curious About the Hormones Behind Your Blood Pressure?
A-List's Blood Pressure Root Cause Test measures aldosterone and renin and reports the aldosterone-to-renin ratio. It's a screening test: your clinician interprets it alongside your medicines and potassium level.
“Book This Panel” opens the secure Stan Store checkout for the Blood Pressure Root Cause Test ($219), where you choose your appointment time and review the total before paying.
Panels that include this test
- Blood Pressure Root Cause Test$219
Every listed panel price includes the required lab order, standard mobile blood collection, collection supplies, and laboratory testing/processing. Only optional upgrades you select (such as the $60 Vein Finder) cost extra. You'll review your selections and final total in Stan Store before paying.
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Educational only. This page explains what a test measures. It does not interpret individual results, diagnose a condition, or recommend treatment. A qualified healthcare professional can help decide which tests make sense for you and what your results mean. Do not change medicines or preparation instructions based on this page.
Sources: Endocrine Society: Primary aldosteronism guideline (2025) · MedlinePlus: Aldosterone test