Primary Aldosteronism, Stroke
Conditions
Keywords
Hypertension, Arrhythmia, Adrenal vein sampling, Mineralocorticoid-receptor Antagonists
Brief summary
Strokes leads to significant morbidity and mortality, and hypertension is the most important risk factor for strokes. It is estimated that up to 10% of patients with hypertension have the underlying, treatable condition of primary aldosteronism. Hence, we hypothesize that the prevalence of primary aldosteronism is high in patients with strokes, a complication of long-standing hypertension. Patients admitted with an acute stroke to the Acute Stroke Unit, Changi General Hospital, will be screened for Primary Aldosteronism three months post-stroke, and confirmatory tests will be done with saline-infusion test.
Interventions
DIAGNOSTIC_TESTAldosterone renin ratio
Aldosterone Renin Ratio to screen for Primary Aldosteronism
Sponsors
Changi General Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
21 Years to 80 Years
Inclusion criteria
1. Age 21-80 years 2. Admitted with acute cerebrovascular accident (CVA) or transient ischemic attack (TIA) to the ASU, CGH 3. Patients with both ischemic and hemorrhagic strokes
Exclusion criteria
a. Pregnant patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of patients with stroke with confirmed primary aldosteronism in patients admitted to the acute stroke unit for stroke | 6 months | Percentage of patients with confirmed Primary Aldosteronism using confirmatory test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of Screening test in early period post-stroke | 3 months | To determine if the screening blood test for primary aldosteronism performed within 1 week post-stroke is equally accurate compared to being performed 2-4 months post-stroke. |
| Percentage of unilateral primary aldosteronism in patients admitted with acute stroke | 6 months | Percentage of unilateral PA amongst patients with stroke |
| Percentage of patients with positive screening test in patients admitted with acute stroke | 3 months | — |
| Blood pressure change after treatment for primary aldosteronism | 12 months | — |
| Cardiac Complications | 6 months | Cardiac complications in patients with primary aldosteronism, compared to those without primary aldosteronism, as assessed by transthoracic echocardiography features of left ventricular hypertrophy / mass, and diastolic dysfunction |
Countries
Singapore
Outcome results
None listed