The year after aldosterone was isolated and characterized, primary aldosteronism ( PA) was recognised as causing hypokalemia and hypertension, in response to hormone secretion inappropriate for sodium levels. This manuscript deals with three time periods since then: the first sixty five years, its current management in a very active clinic in Melbourne, Australia; and finally some suggestions as to improvements in recognition, diagnosis and management over the next five years. We will suggest improvements that endocrinologists, in China and elsewhere, might consider for what has emerged as a major public health issue.