Because of high plasma concentrations of conjugated catecholamines and their unknown relationship to hypertension, we determined those conjugates more specifically as catecholamine sulfates together with the sulfoconjugating enzyme-phenolsulfotransferase activity in platelets of 62 patients with essential hypertension and 32 normal controls. Our results indicated: (1) that the pool of total (free and sulfated) catecholamines (dopamine, norepinephrine, and epinephrine) is higher (because of an increase in dopamine sulfate levels) but the degree of epinephrine conjugation is lower in patients with essential hypertension compared with controls; (2) that norepinephrine sulfate levels rise with age in both groups, but the increase in free norepinephrine with age observed in controls was not observed in patients with essential hypertension; and (3) that catecholamine conjugates were found to be exclusively sulfates and platelet phenolsulfotransferase activity was not different in both groups. Platelet phenolsulfotransferase activity was, however, positively correlated with plasma norepinephrine sulfate levels, and the degree of sulfoconjugation of norepinephrine was positively correlated with that of dopamine in controls but not in patients with essential hypertension. These abnormalities occurring in essential hypertension in the absence of intergroup differences in platelet phenolsulfotransferase activity suggest that the enzyme is either not a good marker of the overall activity or that other factors account for the observed differences. Thus, additional determinants of the process of generation and degradation of sulfoconjugated catecholamines, some of which may be more stable markers of sympathetic activity than free catecholamines, need to be explored.