【Abstract】 Objective To compare the clinical characteristics between idiopathic hyperaldosteronism (IHA) and low renin essential hypertension (LREH) and probe into the association between them in depth. Methods We retrospectively analyzed the clinical data of 119 hypertensive patients, including 25 patients with LREH，49 patients of essential hypertension with normal renin (NREH) and 45 patients with IHA according to the 2016 guidelines of management of primary aldosteronism of endocrine association. Results The plasma renin activity (PRA) and plasma aldosterone concentration (PAC) of LREH patients were lower than NREH patients, but still significantly higher aldosterone renin ratio (ARR)(P＜005). The serum potassium level of IHA patients was lower than that of LREH patients, while the basal PAC and PAC post saline infusion test (SIT) and captopril challenge test (CCT) were significantly higher than LREH patients (P＜005). Patients of two groups had similar PAC reduction rate post SIT and CCT though(P＞005). When we made a subgroup comparison of IHA patients based on ARR on ascending order, we found that plasma renin activity gradually decreasing (P＜005) while PAC remained unchanged (P＞005). Conclusion The clinical variation from low renin essential hypertension to idiopathic hyperaldosteronism may be a continuous course where disorder of reninangiotensinⅡaldosterone system gradually grows obvious.