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. The gene discussed is KCNJ5; the disease is hypertensive disorder.