ArticleEndocrine2025
Prevalence of primary aldosteronism among patients with a history of recent cerebrovascular accident.
Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrimary aldosteronism (PA) is a common but underrecognized cause of secondary hypertension that is associated with a disproportionate cardiovascular risk. We aimed to evaluate the prevalence and predictors of PA among patients with recent (< 3 months) cerebrovascular accident (CVA) treated at our hospital.
methodsIn this prospective cross-sectional study, 172 patients with a recent CVA were evaluated for PA. Patients with a positive screen [plasma direct renin concentration (DRC) < 12 µIU/mL plus plasma aldosterone concentration (PAC) > 10 ng/dL] underwent recumbent saline infusion test (SIT) and a post-SIT PAC > 5 ng/dL confirmed the diagnosis.
resultsEleven (6.4%) patients tested screen positive, of whom two had severe PA (PAC > 20 ng/dL, suppressed renin and hypokalemia). The remaining nine patients underwent confirmatory test, and all had elevated post-SIT PAC > 5 ng/dL, thus accounting for an overall PA prevalence of 6.4%. The prevalence of PA sharply increased with the number of antihypertensive medications used (3.2% in those taking ≤ 1 medication to 25% in those taking ≥ 4 medications) and decreasing serum potassium levels (0% in those with serum potassium > 5 mmol/L to 30% in those with serum potassium < 3.5 mmol/L).
conclusionThe overall prevalence of PA in our cohort was 6.4%. PA should be suspected and screened in patients with CVA, especially in the setting of hypokalemia and increased antihypertensive requirements.
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