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RAAS and stress markers in acute ischemic stroke: preliminary findings.

AbstractOBJECTIVES:
Angiotensin II type 1 receptor blockade has neuroprotective effects in animal stroke models, but no effects in clinical stroke trials. We evaluated cerebral and peripheral changes in the renin angiotensin aldosterone system (RAAS) and stress responses in acute ischemic stroke patients.
MATERIALS AND METHODS:
Blood from a jugular and cubital vein was collected within 48 h of stroke onset, after 24 and 48 h, and renin, angiotensin I, angiotensin II, aldosterone, norepinephrine, epinephrine, and cortisol were measured. Post-stroke cubital vein samples were collected after 8 (4.7-10) months.
RESULTS:
The acute systolic blood pressure was significantly increased, 148 (141-168) vs 140 (130-147) mmHg post-stroke. Angiotensin I, renin and aldosterone levels were significantly lower, angiotensin II was unchanged, and ACE activity was higher in the acute phase compared to post-stroke. No differences in RAAS were detected between jugular and cubital plasma levels. Jugular venous plasma levels of epinephrine and cortisol were elevated in the acute phase compared to cubital levels (P < 0.05).
CONCLUSION:
Increased epinephrine and cortisol levels in the jugular vein blood may reflect a higher peripheral turnover. The observed changes in RAAS in the acute stroke phase are consistent with responses to increased blood pressure.
AuthorsC Back, K L Thiesen, K Skovgaard, L Edvinsson, L T Jensen, V A Larsen, H K Iversen
JournalActa neurologica Scandinavica (Acta Neurol Scand) Vol. 131 Issue 2 Pg. 132-9 (Feb 2015) ISSN: 1600-0404 [Electronic] Denmark
PMID25214428 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chemical References
  • Biomarkers
  • Angiotensin II
  • Aldosterone
  • Renin
Topics
  • Aged
  • Aged, 80 and over
  • Aldosterone (blood)
  • Angiotensin II (blood)
  • Animals
  • Biomarkers (blood)
  • Blood Pressure
  • Female
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Renin (blood)
  • Renin-Angiotensin System (physiology)
  • Stroke (blood, physiopathology)

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