Risk of ischemic stroke in primary aldosteronism patients
Journal
Clinica Chimica Acta
Journal Volume
438
Pages
86-89
Date Issued
2015
Author(s)
Abstract
Background: High aldosterone concentrations are associated with the risk of stroke that is independent of blood pressure levels. We investigated the risk of ischemic stroke in primary aldosteronism (PA) patients. Methods: This retrospective case-control study was based on the Taiwan Primary Aldosteronism Investigation (TAIPAI) database from 2004 to 2010. The study group comprised the patients who developed ischemic stroke after the diagnosis of PA. The PA patients who did not develop stroke were matched according to age and sex as the control group. A multivariate logistic regression model was performed to determine the risk factors of ischemic stroke. Results: Of 339 patients diagnosed with PA, 22 patients (6.5%) developed de novo ischemic stroke. The PA patients with stroke suffered from a longer hypertensive period (11.0. ±. 6.5 vs 7.8. ±. 8.3, P=.007) and a higher prevalence of proteinuria than those who did not develop stroke (40.9% vs 12.9%, P=.002). A multivariate logistic regression model showed that PA patients with proteinuria (HR 3.58, P=.02), preexisting coronary artery disease (HR 11.12, P<.001) or left ventricular hypertrophy (HR 3.09, P=.047) were associated with an increased risk of ischemic stroke. Conclusions: Proteinuria, a medical history of coronary artery disease or left ventricular hypertrophy, was associated with an increased risk of ischemic stroke in PA patients. Our results suggest that a public health initiative is necessary to enhance the follow-up of proteinuria and to manage subsequent stroke among patients with aldosteronism. ? 2014 Elsevier B.V.
SDGs
Other Subjects
adult; article; brain ischemia; comorbidity; controlled study; coronary artery disease; disease association; disease course; disease duration; female; heart left ventricle hypertrophy; high risk patient; human; hypertension; major clinical study; male; medical history; middle aged; neuropathology; primary hyperaldosteronism; priority journal; proteinuria; risk assessment; risk factor; brain ischemia; case control study; cerebrovascular accident; complication; hyperaldosteronism; retrospective study; Taiwan; Article; brain ischemia; cardiovascular risk; computer assisted tomography; family history; nuclear magnetic resonance imaging; plasma renin activity; prevalence; primary hyperaldosteronism; public health; Adult; Brain Ischemia; Case-Control Studies; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Retrospective Studies; Stroke; Taiwan
Type
journal article