This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Scientific Rationale: Aldosterone excess may be a more common cause of or contributing factor to hypertension than previously known with reported prevalence rates of 8-32% depending on the patient population being screened. The accuracy of the RUS to diagnose aldosterone excess is unknown. The accuracy of albumin and protein measurements in RUS compared to those in timed urine collection (overnight or 24 hour) has been demonstrated. Using a similar approach, we seek to determine the performance of aldosterone measurement in RUS for the diagnosis of aldosterone excess.
Specific Aims : 1) To assess the performance of measurements of urinary aldosterone concentration (UAC) and urinary aldosterone:creatinine ratio (UACR) in a random urine specimen (RUS) in predicting excess urinary aldosterone excretion. 2) To gather preliminary data for the support of an RO1-type application assessing urinary aldosterone excretion in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Long-term Aims: 1) To assess the degree to which geographic or racial differences in hypertension prevalence and severity are attributable to geographic or racial variations in urinary aldosterone excretion. 2) To assess the degree to which geographic or racial differences in stroke incidence and case fatality are attributable to geographic or racial variations in urinary aldosterone excretion.
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