Cognitive impairment contributes significantly to global mortality and disability. Primary aldosteronism (PA) is a condition characterized by inappropriately high aldosterone concentrations that lead to numerous adverse effects, ranging from arterial hypertension and hypokalemia to unfavorable effects on the kidney, heart, and vasculature. There is evidence of a higher incidence of cardiovascular and cerebrovascular events in individuals with PA compared to individuals of the same age and sex with essential hypertension. Aldosterone acts in the central nervous system to promote cerebrovascular remodeling, vascular inflammation and oxidative stress, resulting in impaired regulation of cerebral blood flow, which may impact cognitive function. Furthermore, mineralocorticoid receptors are expressed in the hippocampus, which plays a significant role in human cognitive function.We conducted a study on 15 individuals with PA and arterial hypertension, along with 15 age- and sex-matched controls with essential hypertension, in order to determine differences in cognitive function between individuals with PA and consequent hypertension compared to controls with essential hypertension. We analyzed the general characteristics of the participants and the results of cognitive assessment tests: Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). There were no statistically significant differences between the participants and controls in years of education, body mass index, waist circumference or the number of antihypertensive medications used. Individuals with PA had expectedly higher blood pressure values and lower serum potassium levels compared to controls (155.3 ±17.9 vs 135.4 ±12.2 mmHg, p = 0.001 for systolic blood pressure; 99.3±13.1 vs 87.6±4.9 mmHg, p=0.005 for diastolic blood pressure; 3.6±0.5 vs 4.4±0.4 mmol/l, p<0.001 for serum potassium). There was no difference in MMSE scores between the participants and controls. However, a significant difference was found in MoCA scores between individuals with PA and controls, with PA individuals exhibiting poorer performance (25.13±2.23 vs 27.13±2.23, p = 0.021). We observed a trend of lower scores in individuals with PA in the language and attention and concentration domains (2 (2-3) vs 3 (1-3), p > 0.05 and 6 (3-6) vs 6 (5-6), p > 0.05, respectively). We also noticed a trend of a higher number of individuals with pathological total MoCA scores compared to the control group (7 vs 3, p > 0.05). We did not find any significant associations between cognitive test results and aldosterone concentrations or the aldosterone-to-renin ratio in individuals with PA, nor did we observe correlations with blood pressure (p > 0.05).The results of this study support the association between hyperaldosteronism and cognitive dysfunction and provide a solid foundation for further research with a larger number of participants and more analyzed parameters.