Primary hyperaldosteronism (PHA) as the most common cause of secondary arterial hypertension (AH), and accounts for 10–15% of cases according to the literature. However, the true prevalence of PHA is underestimated due to the lack of clear, understandable diagnostic algorithms for primary care physicians and incorrect interpretation of results. This is especially true for “mild” forms of the disease. Despite the lack of a clear clinical picture, PHA is associated with a higher risk of adverse cardiovascular events and metabolic disorders compared with essential AH, even when blood pressure target levels are achieved. Understanding the new pathogenetic aspects of PHA, in particular the connection between the clinical form of the disease and somatic mutations of ion channels that accumulate with age, is intended to make the diagnosis of PHA more convenient for everyday clinical practice and, thus, increase the effectiveness of treatment and the quality of life of patients.

Keywords: adrenal hyperplasia, aldosteroma, primary hyperaldosteronism, hypokalemia, resistant arterial hypertension