What are normal aldosterone levels in adults?

From the Guidelines

Normal aldosterone levels in adults typically range from 3 to 16 ng/dL when measured in the morning while the person is upright or standing, as stated in the 2018 guideline by the American College of Cardiology/American Heart Association task force on clinical practice guidelines 1.

Key Points to Consider

• Aldosterone levels can vary based on posture, with higher levels when standing due to activation of the renin-angiotensin-aldosterone system.
• The body naturally adjusts aldosterone production based on salt intake and time of day.
• Factors that can affect aldosterone levels include dietary sodium intake, medications (especially diuretics, ACE inhibitors, and ARBs), stress, and pregnancy.
• Abnormal aldosterone levels may indicate conditions such as primary aldosteronism (Conn's syndrome), adrenal insufficiency, or certain kidney disorders.

Diagnostic Considerations

• The aldosterone:renin activity ratio is currently the most accurate and reliable means of screening for primary aldosteronism, with a commonly used cutoff value of 30 when plasma aldosterone concentration is reported in nanograms per deciliter (ng/dL) and plasma renin activity in nanograms per milliliter per hour (ng/mL/h) 1.
• Patients should have unrestricted salt intake, serum potassium in the normal range, and mineralocorticoid receptor antagonists (e.g., spironolactone or eplerenone) withdrawn for at least 4 weeks before testing.

Treatment Implications

• If the diagnosis of primary aldosteronism is confirmed, treatment options include unilateral laparoscopic adrenalectomy or medical therapy with spironolactone or eplerenone, both of which can effectively lower blood pressure and reverse left ventricular hypertrophy (LVH) 1.

From the Research

Normal Aldosterone Levels in Adults

• The normal aldosterone levels in adults are not explicitly stated in the provided studies 2, 3, 4, 5, 6.
• However, the studies discuss the diagnosis and treatment of primary aldosteronism, which is characterized by excess aldosterone production.
• The diagnosis of primary aldosteronism involves measuring plasma aldosterone concentration and plasma renin activity, and calculating the aldosterone-renin ratio (ARR) 2, 3, 4.
• An elevated ARR (greater than 30) indicates independent aldosterone secretion, and confirmatory tests such as the captopril challenge, oral or intravenous salt loading, or fludrocortisone suppression are used to confirm the diagnosis 2, 3, 4.
• The studies do not provide specific reference values for normal aldosterone levels in adults, but they discuss the importance of screening for primary aldosteronism in patients with hypertension 5, 6.

Diagnosis and Treatment of Primary Aldosteronism

• Primary aldosteronism is a common cause of secondary hypertension, and it can be cured surgically or treated with targeting medical treatment 3, 6.
• The diagnosis of primary aldosteronism involves a combination of clinical evaluation, laboratory tests, and imaging studies 2, 3, 4, 5, 6.
• The treatment of primary aldosteronism depends on the underlying cause and may involve surgery, medication, or a combination of both 2, 3, 4, 5, 6.
• Mineralocorticoid receptor antagonists such as spironolactone or eplerenone are commonly used to treat primary aldosteronism 2, 3, 4.