Hypertension is a common clinical disease, the vast majority of hypertension is without a clear cause, called primary hypertension, which is generally considered to account for about 90%; the other 10% is secondary hypertension, that is, to find a clear cause of hypertension, including secondary to kidney disease, endocrine disease, vascular disease and other hypertension, also known as symptomatic hypertension. Studies in the past 10 years have shown that many hypertensive diseases with unclear causes are now able to identify the cause. Some of them are endocrine hypertension. This is a group of diseases characterized by hypertension combined with hypokalemia. Patients often have intractable hypertension and their blood pressure cannot be easily lowered to a satisfactory level with the usual blood pressure lowering drugs, and hypokalemia causes muscle weakness and cardiac arrhythmias. It has been considered a very rare case in the past, accounting for about 0.5-2% of the hypertensive population, and reports in the last 10 years have found its incidence to be much higher than originally expected. Clinical studies have reported screening in hypertensive patients with or without hypokalemia, with an overall prevalence of about 6% of the hypertensive population, with some reports reaching 30%, suggesting that a significant proportion of the hypertensive population is affected by primary hyperaldosteronism. In addition to the large number of patients with primary aldosteronism hidden in hypertension, there are also patients with hypertension caused by subclinical cortisolism, pheochromocytoma with atypical symptoms and other endocrine diseases that are not yet clinically evident, and they may also be treated as general hypertension without screening. Why is it important to screen for endocrine hypertension from patients with hypertensive disorders? Endocrine hypertension is a group of diseases with a clear etiology. Before a clear diagnosis is made, common antihypertensive treatment is often ineffective, and long-term poor blood pressure control may cause a variety of cardiovascular, cerebrovascular, renal and ocular complications. Some patients may be treated with specific medications to achieve radical relief. If these patients are not seen in a timely manner, they may miss the opportunity for treatment and delay their condition. Which patients with hypertension should be treated by endocrinology? Patients with a young age of onset; those with a family history; those with specific clinical manifestations: obesity, emaciation, swelling, weakness, growing hands and feet in adulthood; those with significant fluctuations in blood pressure, pale or flushed face, sweating, headache, etc.; those with male feminization (breast development is the most common) or female masculinization (male hair distribution is the most common); those with obesity, hyperglycemia, hyperlipidemia, acanthosis nigricans (i.e., rough skin on the back of the neck, axillae and groin); and those with a high blood pressure. The skin of the back of the neck, armpits and groin is rough and dark); and those who are not satisfied with the effect of general blood pressure lowering treatment. Patients with hypertension who have the above symptoms should visit the endocrinology department to check whether it is endocrine hypertension to avoid delaying treatment.