The overall objective of the project is the detection and definition of abnormalities in the secretory pattern of steroid-producing organs and in the peripheral metabolism of their products. Efforts will be concentrated in a juvenile hypertensive syndrome resembling primary aldosteronism but with subnormal production of all known steroids. An abnormality has been detected in these patients consisting of a defect in the reductive metabolism of the steroid ring A, with accumulation of corticosteroid 4,5-dihydro metabolites, and the excretion of 3-keto metabolites in the urine in unconjugated form. There also is an abnormal predominance of 5 alpha-dihydro epimers relative to the 5 beta forms. The normal cortisol yields (reversibly) cortisone equilibrium is also abnormal with a shift to the left and decreased rate of conversion to cortisone.