Hypertension is known to be the major risk factor for stroke. The most common cause of secondary hypertension, primary aldosteronism (PA), is characterized by the excessive secretion of aldosterone and is related to hypertension and hypokalemia. PA accounts for 3-10 % of hypertensive patients, and a higher incidence of vascular complications compared to patients with essential hypertension was observed in several studies. The vascular injury from excessive aldosterone can occur via oxidative stress and collagen remodeling, causing endothelial dysfunction and fibrosis in the vasculature.

The association between cerebral small vessel disease (cSVD) and hypertension has been well studies in the past decades. However, not much study has focused on the cSVD burden in patient with PA. The goal of this study is to understand the features of cSVD in patients with PA and for the purpose of understanding the underlying pathophysiology of cerebrovascular injury in this particular patient group.

Inclusion Criteria:

• age between 20-90 years-old
• patient with primary aldosteronism or healthy control
• consciousness clear
• willing to receive brain MRI

Exclusion Criteria:

• renal failure or Creatinine > 2mg/dl
• coagulopathy or hepatic insufficiency
• unstable vital sign under inotropic agents
• pregnancy
• metal implant or cardiac pacemaker
• major brain surgery