Adrenalectomy for unilateral PA driven by somatic mutations (e.g., KCNJ5) offers markedly superior outcomes over medical therapy, yielding an absolute risk reduction in all-cause mortality that rivals or exceeds many major cardiovascular surgeries and greatly improves quality of life by resolving hypertension, hypokalemia, and associated symptoms. This evidence concerns the gene KCNJ5 and Hypokalemia.