A 52-year-old previously healthy woman with no family history of endocrine disease was admitted to our hospital with suspected PA based on high blood pressure (193/105 mmHg), spontaneous hypokalemia (potassium [K], 3.4 mmol/L), and a high aldosterone-to-renin ratio (ARR 71 ng/dL per ng/mL/h [plasma renin activity (PRA) 0.2 ng/mL/h and plasma aldosterone concentration (PAC) 14.2 ng/dL]). This evidence concerns the gene REN and endocrine system disorder.