Background: Hypertension (HTN) affects between 10 to 40% of the general population and is considered as risk factor for premature death in the world. Primary aldosteronism (PA) is the most common form of secondary hypertension. Primary aldosteronism causes more end-organ damage and is associated with excess cardiovascular morbidity and strokes. Screening is simple and readily available. Also, targeted therapy improves blood pressure control and decreases mortality rates. Aim of the work: to screen primary aldosteronism in hypertensive patients at high risk with an estimation of PA prevalence within the Egyptian hypertensive population and to identify “low renin hypertension” patients as a subset in need of specific preventive and therapeutic strategy