{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:30:10Z","timestamp":1787679010685,"version":"build-2784847793"},"reference-count":72,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Primary aldosteronism confers a higher risk of stroke, atrial fibrillation, and cardiovascular disease than blood pressure matched essential hypertension. It is the most common endocrine cause of secondary hypertension with prevalence estimates of up to 13% in primary care and 30% in referral centers around the world. Unlike essential hypertension, primary aldosteronism has targeted medical treatment and potentially curative surgical solutions which can ameliorate the associated cardiovascular risks. This narrative review highlights an evidence gap in the optimal diagnosis and targeted treatment of primary aldosteronism in secondary stroke prevention. Over half of the patients suffering a stroke have blood pressure in the hypertensive range and less than a third achieve optimal blood pressure control. There are no guideline recommendations to test for primary aldosteronism in these patients, although up to 30% of patients with resistant hypertension may have this disease. The accurate diagnosis of primary aldosteronism could significantly improve blood pressure, simplify the medication regimen and reduce the overall cardiovascular risk in these patients. The challenges associated with screening for primary aldosteronism following stroke may be overcome by novel blood tests which are less affected by antihypertensive medications routinely used in stroke care. Approximately one-quarter of all strokes occur in patients who have previously had a stroke. Modifying hypertension, the leading modifiable risk factor, would, therefore, have significant public health implications. As clinicians, we must increase our awareness of primary aldosteronism in patients with stroke, particularly in those with resistant hypertension, to enable targeted therapy and reduce the risk of stroke recurrence.<\/jats:p>","DOI":"10.1161\/strokeaha.120.033990","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T09:00:24Z","timestamp":1629882024000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Hypertension Management in Stroke Prevention"],"prefix":"10.1161","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-2608","authenticated-orcid":true,"given":"Josephine","family":"McCarthy","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Eastern Health, Box Hill, Australia (J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":true,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Australia (J.Y., M.J.Y., P.J.F.)."},{"name":"Departments of Endocrinology (J.Y., P.J.F.), Monash Health, Clayton, Australia."},{"name":"Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia (J.Y., B.C., T.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Clissold","sequence":"additional","affiliation":[{"name":"Neurology (B.C., T.P.), Monash Health, Clayton, Australia."},{"name":"Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia (J.Y., B.C., T.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0450-5375","authenticated-orcid":true,"given":"Morag J.","family":"Young","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Australia (J.Y., M.J.Y., P.J.F.)."},{"name":"Baker Heart and Diabetes Institute, Melbourne, Australia (M.J.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Australia (J.Y., M.J.Y., P.J.F.)."},{"name":"Departments of Endocrinology (J.Y., P.J.F.), Monash Health, Clayton, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh","family":"Phan","sequence":"additional","affiliation":[{"name":"Neurology (B.C., T.P.), Monash Health, Clayton, Australia."},{"name":"Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia (J.Y., B.C., T.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-015-0466-2"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31134-5"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1964.03070160046009"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.7326\/M20-0065"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30319-4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30367-4"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-020-0336-2"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308398"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31828124ad"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11609"},{"key":"e_1_3_4_13_2","unstructured":"Australian Institute of Health and Welfare. 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