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Abstract Hypertension (HTN) affects between 10 to 40% of the general population and is the leading risk factor for premature death in the world Primary aldosteronism (PA) is the most common form of secondary hypertension. PA causes more end-organ damage and is associated with excess cardiovascular morbidity, including heart failure, stroke, nonfatal myocardial infarction, and atrial fibrillation. Screening is simple and readily available, and targeted therapy improves blood pressure control and mitigates cardiovascular morbidity The aldosteronejrenin ratio (ARR) is the most reliable means to screen for PA. Active renin concentration (ARC) was used as a component of measurement during the calculation of ARR in our study. Fludrocortisone Suppression Testing (FST) is one of the confirmatory tests which used in our study inpatient positive ARR. For subtyping classification of PA adrenal computed tomography (CT) scan was used as the initial study in subtype testing and to exclude large masses(>4 em) that may represent adrenocortical carcinoma. The aim of our study, a Prospective randomized-controlled observational cohort study, is to screen primary aldosteronism (PA) 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 for specific preventive and therapeutic strategy |