Cardiovascular Endocrinology

ORF23-02 - Screening Yield and Predictors of Positive Primary Aldosteronism Screening

Sunday, June 14, 2026

9:35 AM - 9:40 AM CT

Location: Room W185ABC

Rapid and Poster Presenter(s)

Naykky Maruquel Singh Ospina, MD

Associate Professor
University of Florida
Gainesville, Florida, United States

Co-Author(s)

DV

Diana Grace Varghese, MD (she/her/hers)

Clinical Fellow
University of Maryland School of Medicine
Baltimore, MD, United States
MT

Mark A. Takagi, II, MEng

Mayo Clinic
Rochester, Minnesota, United States
YD

Yihong Deng, PhD

Mayo Clinic
Rochester, United States
AT

Adina F. Turcu, MD

University of Michigan,
Ann Arbor, Michigan, United States
CS

Carolyn D. Seib, MD, MAS

Stanford University
Stanford, California, United States
Spyridoula Maraka, MD

Chief, Endocrine Section
Central Arkansas Veteran Healthcare System
Little Rock, Arkansas, United States
RM

Rozalina G. McCoy, MD, MD

University of Maryland School of Medicine
Baltimore, Maryland, United States
Irina Bancos, MD (she/her/hers)

Professor of Medicine, Division of Endocrinology
Mayo Clinic Rochester
Rochester, MN, United States
MO

Mei-Sing Ong, PhD

Boston Children's Hospital
Boston, United States
Juan P. Brito, MD

Mayo Clinic
Rochester, MN, United States

Disclosure(s):

Diana Grace Varghese, MD, FACP: No financial relationships to disclose

Background: Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. PA screening is accomplished by concomitant aldosterone and renin measurements. The rates of positive screening and variations across population subgroups are understudied.

Methods: We conducted a retrospective cohort study using the Optum Labs Data Warehouse. We identified adults with incident hypertension between 2011 and 2023 and paired measurements of renin and aldosterone. Suppressed renin was defined as ≤1 ng/mL/h or < 8 pg/mL, and positive screening was defined by suppressed renin with aldosterone ≥10 ng/dL. Multivariable regression was used to identify predictors of positive screening.

Results: We identified 9,414 patients with incident hypertension and laboratory results for paired renin and aldosterone. The mean age was 52 (SD16) years, 56% were women and 58% White. Positive PA screening occurred in 819 (8.7%) patients.

In multivariable regression analyses, factors associated with positive screening included: older age compared with age < 25 years, ranging from OR 2.46 (95% CI 1.16–5.21) for ages 25–34 to OR 4.03 (95% CI 1.49–10.91) for ages ≥75; female sex (OR 1.37, 95% CI 1.16–1.61); Hispanic/Latino ethnicity (OR 1.36, 95% CI 1.06–1.74), Black race (OR 1.80, 95% CI 1.42–2.28), and Asian (OR 1.91, 95% CI 1.39–2.63) all compared to White individuals; hypokalemia (OR 1.50, 95% CI 1.19–1.88); and diabetes mellitus (OR 1.26, 95% CI 1.03–1.54). Conversely, heart failure (OR 0.54, 95% CI 0.35–0.84) was associated with lower odds of positive PA screening. Odds of positive PA screening were lower with RAAS inhibitors (OR 0.78, 95% CI 0.66–0.92) and higher with beta blockers (OR 1.45, 95% CI 1.23–1.71), calcium channel blockers (OR 1.30, 95% CI 1.10–1.52), and potassium supplementation (OR 1.66, 95% CI 1.28–2.16).

Conclusion: In a large real-world cohort of patients with incident hypertension, the positive screening rate for PA was 9%, with substantial variation across demographic, clinical, and medication-related subgroups. These findings may inform screening strategies.