Uslar and colleagues show how an incidental adrenal adenoma can prompt a useful reassessment of hypertension [1]. Their prospective cohort identified suppressed renin in 138 of 290 patients, and substantial blood pressure reductions followed aldosterone-targeted treatment, including in patients with plasma aldosterone concentrations (PAC) of 5–10 ng/dL. Three additions, where follow-up data permit, could clarify the implications for routine care: outcomes by treatment, completeness of data in the lower-PAC subgroup, and adverse effects and monitoring requirements.
