Prevalence of Primary Aldosteronism in Patients With Stroke

Study Overview
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Brief Summary
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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.

Official Title
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Prevalence of Primary Aldosteronism in Patients With Stroke

Conditions
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Primary Aldosteronism, Stroke

Intervention / Treatment
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* Diagnostic Test: Aldosterone renin ratio


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 21-80 years Admitted with acute cerebrovascular accident (CVA) or transient ischemic attack (TIA) to the ASU, CGH Patients with both ischemic and hemorrhagic strokes Exclusion Criteria: a. Pregnant patients

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Single Arm<br>All patients admitted to the Acute Stroke Unit | Diagnostic Test: Aldosterone renin ratio<br>* Aldosterone Renin Ratio to screen for Primary Aldosteronism<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients with stroke with confirmed primary aldosteronism in patients admitted to the acute stroke unit for stroke | Percentage of patients with confirmed Primary Aldosteronism using confirmatory test | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of Screening test in early period post-stroke | 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. | 3 months | 
| Percentage of unilateral primary aldosteronism in patients admitted with acute stroke | Percentage of unilateral PA amongst patients with stroke | 6 months | 
| 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 | 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 | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hypertension, Arrhythmia, Adrenal vein sampling, Mineralocorticoid-receptor Antagonists