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- Title
Primary aldosteronism in patients with acute stroke: prevalence and diagnosis during initial hospitalization.
- Authors
Yosuke Miyaji; Yuichi Kawabata; Hideto Joki; Shunsuke Seki; Kentaro Mori; Tomoya Kamide; Akira Tamase; Hiroshi Shima; Motohiro Nomura; Yoshihisa Kitamura; Hirotatsu Nakaguchi; Taichi Minami; Tetsuji Tsunoda; Mayuko Sasaki; Masayo Yamada; Fumiaki Tanaka; Miyaji, Yosuke; Kawabata, Yuichi; Joki, Hideto; Seki, Shunsuke
- Abstract
<bold>Background: </bold>Hypertension is the prime risk factor for stroke, and primary aldosteronism (PA) is the most common cause of secondary hypertension. The prevalence of PA in stroke patients has never been reported. The aim of this study was to elucidate the prevalence of PA.<bold>Methods: </bold>A total of 427 consecutive patients with acute stroke were prospectively enrolled for this study. The screening tests were performed at the initial visit and a week after admission by measuring plasma aldosterone concentration and plasma renin activity. The rapid adrenocorticotropic hormone (ACTH) test was performed as the confirmatory test when both screening tests were positive. The primary endpoint was a final diagnosis of PA.<bold>Results: </bold>The sensitivity of the dual screening system for the diagnosis of PA was 88.2 %, and PA was finally diagnosed in 4.0 % of acute stroke patients and in 4.9 % of stroke patients with a history of hypertension. Patients with PA were less likely to be male and have diabetes, and they had higher blood pressure at the initial visit, lower potassium concentration, and more intracerebral hemorrhage. The rapid ACTH test was performed safely even in acute stroke patients.<bold>Conclusions: </bold>The prevalence of PA is not low among acute stroke patients. Efficient screening of PA should be performed particularly for patients with risk factors.<bold>Trial Registration: </bold>UMIN-CTR; UMIN000011021 . Trial registration date: June 23, 2013 (retrospectively registered).
- Subjects
JAPAN; HYPERALDOSTERONISM; STROKE patients; STROKE diagnosis; HYPERTENSION; PATIENTS; MEDICAL care; DIAGNOSIS of endocrine diseases; HYPERTENSION epidemiology; ALDOSTERONE; HOSPITAL care; RENIN; STROKE; COMORBIDITY; DISEASE prevalence; RETROSPECTIVE studies; DIAGNOSIS
- Publication
BMC Neurology, 2016, Vol 16, p1
- ISSN
1471-2377
- Publication type
journal article
- DOI
10.1186/s12883-016-0701-5