Endocrine Abstracts (2009) 20 P15

Prediction of fatal stroke by high serum aldosterone levels

Andreas Tomaschitz1, Stefan Pilz1, Harald Dobnig1, Bernhard R Winkelmann2, Wilfried Renner3, Bernhard O Boehm4 & Winfried Maerz3,5

1Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria; 2Cardiology Group, Frankfurt-Sachsenhausen, Frankfurt, Germany; 3Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; 4Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Ulm, Ulm, Germany; 5Synlab Center of Laboratory Diagnostics Heidelberg, Eppelheim, Germany.

Background: There is increasing evidence that aldosterone exerts deleterious, blood pressure independent effects on cerebral blood vessels. We aimed to evaluate whether high aldosterone levels are related to fatal stroke.

Methods: Serum aldosterone concentrations (SAC, pg/ml) were measured in 3073 Caucasian patients, who were routinely referred to coronary angiography. We calculated Cox proportional hazard ratios for death due to fatal stroke according to SAC quartiles.

Results: During a median follow-up time of 7.75 years 769 patients died, including 37 individuals with a diagnosis of fatal stroke (ischemic or hemorrhagic). After multivariate adjustment for age, sex, common vascular risk factors including arterial blood pressure and statin use, the hazard ratio for death due to fatal stroke was 2.78 (95% CI 1.02–7.58; P=0.046), when comparing patients within the highest SAC quartile (median SAC 16.8) to the lowest SAC quartile (median SAC 3.4).

Conclusions: High aldosterone levels are associated with death due to fatal stroke independent of multiple vascular risk factors. Our results suggest that mineralocorticoid blocking strategy might be beneficial for prevention of fatal cerebrovascular events.

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