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Blood pressure lowering in the oldest old: a step toward abandoning arbitrary blood pressure targets.

We read with interest the paper of Parthasarathy et al. [1], investigating the blood pressure (BP) response to two different diuretics [a mineralocorticoid receptor antagonist (MRA) and a thiazide diuretic] in patients subdivided, according to aldosterone-to-renin ratio (ARR) value, in high and low ARR group, respectively. Given the high incidence of primary aldosteronism and the widely recognized adverse effects of aldosterone on cardiovascular system, further research on MRA use in hypertensive patients is warranted.