Risk of ischemic stroke in primary aldosteronism patients

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