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We investigated the effects on the heart of hypertension due to the excess of aldosterone and suppression of the renin-angiotensin system caused by primary aldosteronism with M-mode echocardiography and transmitral Doppler flow velocity measurements. We studied 34 consecutive patients with primary aldosteronism and 34 with essential hypertension individually matched for age, gender, race, body mass index, blood pressure values, and duration of hypertension. The groups were similar in age, body mass index, blood pressure, and duration of hypertension. However, lower serum potassium levels (3.5±0.6 versus 4.1±0.2 mmol/L, P<.0001) and plasma renin activity (0.53±0.45 versus 1.82±1.59 ng Ang I·mL⁻¹·h⁻¹, P<.0001) and higher plasma aldosterone levels (1107±774 versus 206±99 pmol/L, P<.0001), left ventricular wall thickness, and left ventricular mass index (112±4.7 versus 98±3.7 g/m², P=.029 …