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2016 ; 16
(ä): 177
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Primary aldosteronism in patients with acute stroke: prevalence and diagnosis
during initial hospitalization
#MMPMID27639696
Miyaji Y
; Kawabata Y
; Joki H
; Seki S
; Mori K
; Kamide T
; Tamase A
; Shima H
; Nomura M
; Kitamura Y
; Nakaguchi H
; Minami T
; Tsunoda T
; Sasaki M
; Yamada M
; Tanaka F
BMC Neurol
2016[Sep]; 16
(ä): 177
PMID27639696
show ga
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: The prevalence of PA is not low among acute stroke
patients. Efficient screening of PA should be performed particularly for patients
with risk factors. TRIAL REGISTRATION: UMIN-CTR; UMIN000011021 . Trial
registration date: June 23, 2013 (retrospectively registered).