Primary aldosteronism and obstructive sleep apnea a cross-sectional multi-ethnic study
Journal
Hypertension
Journal Volume
74
Journal Issue
6
Pages
1532-1540
Date Issued
2019
Author(s)
Buffolo F.
Li Q.
Monticone S.
Heinrich D.A.
Mattei A.
Pieroni J.
Mei M.
Yang S.
Hu Y.-H.
Yang M.-C.
Sabbadin C.
Pizzolo F.
Giacchetti G.
Fallo F.
Veglio F.
Reincke M.
Mulatero P.
Abstract
The association between primary aldosteronism (PA) and obstructive sleep apnea (OSA) has been a matter of debate. 2016 Endocrine Society guideline recommends screening for PA all hypertensive patients with OSA. We designed a multicenter, multiethnic, cross-sectional study to evaluate the prevalence of PA in patients with OSA and the prevalence of OSA in unselected patients with PA. Two hundred and three patients with OSA (102 whites and 101 Chinese) were screened for PA, and 207 patients with PA (104 whites, 100 Chinese, and 3 of African descent) were screened for OSA by cardiorespiratory polygraphy. Eighteen patients with OSA (8.9%) had PA (11.8% of white and 5.9% of Chinese ethnicity). In patients without other indications for PA screening, the prevalence of PA dropped to 1.5%. The prevalence of OSA in patients with PA was 67.6%, consistent in both white and Chinese patients. A correlation between aldosterone levels and apnea/hypopnea index was observed in white patients with PA (R2=0.225, P=0.016) but not in Chinese patients. Multinomial logistic regression confirmed a significant and independent association between plasma aldosterone levels and moderate to severe OSA diagnosis in white patients (odds ratio, 1.002; P=0.002). In conclusion, aldosterone levels may contribute to the severity of OSA in white patients with hyperaldosteronism, but patients with OSA are not at high risk of PA. Results of the present study challenge the current recommendation of the Endocrine Society guideline that all patients with OSA should be screened for PA, irrespective of the grade of hypertension. ? 2019 American Heart Association, Inc.
SDGs
Other Subjects
aldosterone; adult; African; aldosterone blood level; apnea hypopnea index; Article; Caucasian; Chinese; controlled study; cross-sectional study; diabetes mellitus; female; human; hypertension; hypertensive patient; major clinical study; male; metabolic syndrome X; multicenter study; practice guideline; prevalence; primary hyperaldosteronism; priority journal; screening; sleep disordered breathing; age; blood pressure measurement; clinical trial; comorbidity; comparative study; ethnic group; ethnology; follow up; Germany; hyperaldosteronism; hypertension; international cooperation; middle aged; nonparametric test; polysomnography; procedures; risk assessment; severity of illness index; sex factor; sleep disordered breathing; Adult; Age Factors; Blood Pressure Determination; Comorbidity; Cross-Sectional Studies; Ethnic Groups; Female; Follow-Up Studies; Germany; Humans; Hyperaldosteronism; Hypertension; Internationality; Male; Middle Aged; Polysomnography; Prevalence; Risk Assessment; Severity of Illness Index; Sex Factors; Sleep Apnea, Obstructive; Statistics, Nonparametric
Publisher
Lippincott Williams and Wilkins
Type
journal article