https://scholars.lib.ntu.edu.tw/handle/123456789/637598
標題: | Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage | 作者: | BO-CHING LEE Tsai, Hsin-Hsi Chen, Zheng-Wei CHIN-CHEN CHANG Huang, Jia-Zheng Chang, Yi-Yao CHENG-HSUAN TSAI Chou, Chia-Hung CHE-WEI LIAO CHIEN-TING PAN VIN-CENT WU CHI-SHENG HUNG LI-KAI TSAI YEN-HUNG LIN TAI-SHUAN LAI SHIH-CHIEH CHUEH SHAO-YU YANG KUO-HOW HUANG CHIEH-KAI CHAN SHUO-MENG WANG KAO-LANG LIU CHING-CHU LU |
關鍵字: | Cerebral small vessel disease; Hypertension; Intracerebral hemorrhage; Perivascular space; Primary aldosteronism | 公開日期: | 22-十一月-2023 | 來源出版物: | Hypertension research : official journal of the Japanese Society of Hypertension | 摘要: | Primary aldosteronism is associated with various types of cardiovascular and cerebrovascular damage independently of hypertension. Although chronic hypertension and related cerebral arteriosclerosis are the main risk factors for intracerebral hemorrhage, the effects of aldosteronism remain poorly understood. We enrolled 90 survivors of hypertensive intracerebral hemorrhage, 21 of them with aldosteronism and 69 with essential hypertension as controls in this study. Clinical parameters and neuroimaging markers of cerebral small vessel disease were recorded, and its correlations with aldosteronism were investigated. Our results showed that the aldosteronism group (55.2 ± 9.7 years, male 47.6%) had similar hypertension severity but exhibited a higher cerebral microbleed count (interquartile range) (8.5 [2.0‒25.8] vs 3 [1.0‒6.0], P = 0.005) and higher severity of dilated perivascular space in the basal ganglia (severe perivascular space [number >20], 52.4% vs. 24.6%, P = 0.029; large perivascular space [>3 mm], 52.4% vs. 20.3%, P = 0.010), compared to those with essential hypertension (53.8 ± 11.7 years, male 73.9%). In multivariate models, aldosteronism remained an independent predictor of a higher (>10) microbleed count (odds ratio = 8.60, P = 0.004), severe perivascular space (odds ratio = 4.00, P = 0.038); the aldosterone-to-renin ratio was associated with dilated perivascular space (P = 0.043) and large perivascular space (P = 0.008). In conclusions, survivors of intracerebral hemorrhage with aldosteronism showed a tendency towards more severe hypertensive arteriopathy than the essential hypertension counterparts independently of blood pressure; aldosteronism may contribute to dilated perivascular space around the deep perforating arteries. Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/637598 | ISSN: | 09169636 | DOI: | 10.1038/s41440-023-01458-w |
顯示於: | 醫學系 |
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