Association of objective and subjective parameters of obstructive sleep apnea with plasma aldosterone concentration in 2,066 hypertensive and 25,368 general population

Abstract

Study objectivesObstructive sleep apnea (OSA) severity has been suggested in aldosterone elevation in resistant hypertension, whereas it is undetermined in the rest population. We explored the association of OSA parameters with plasma aldosterone concentration (PAC) in participants with and without hypertension.MethodsWe enrolled clinically hypertensive patients with polysomnography and PAC data under no interfering agents, compared (log) PAC, and assessed the linearity of log PAC by tertiles (T1/2/3) of sleep parameters and their association using linear regression by gender and age. We enrolled participants with and without hypertension who had No-SAS scale and PAC data from the community and duplicated the observations from clinical setting considering age, gender, and presence of hypertension.ResultsOf the 2,066 clinical patients with hypertension (1,546 with OSA), men participants (n=1,412), log apnea–hypopnea index (p=0.043), apnea index (AI, p=0.010), and lowest oxygen saturation (LSaO2, p=0.013) showed significant linearity with log PAC. Log AI (B=0.04, 95%CI: 0.01,0.07, p=0.022) and log LSaO2 (B=−0.39, 95%CI: −0.78,−0.01, p=0.044) showed significant positive and negative linear associations with log PAC in regression. In community dwellers, 6,417 participants with untreated hypertension (2,642 with OSA) and 18,951 normotensive participants (3,000 with OSA) were included. Of the men participants with and without hypertension, the OSA group showed significantly higher (log) PAC than did their counterparts, and log No-SAS score showed positive association with log PAC (hypertension: B=0.072, 95%CI: 0.002,0.142, p=0.043; normotension: B=0.103, 95%CI: 0.067,0.139, p<0.001) in linear regression analysis, which were consistent in all age groups.ConclusionsOSA parameters were positively associated with PAC in normotensive and hypertensive participants, indicating that OSA may increase circulating aldosterone, especially in men.

Associated lifestyle factors of elevated plasma aldosterone concentration in community population, gender-stratified analysis of a cross-sectional survey

“…Therefore, the aim of this study was to analyze the factors associated with elevated plasma aldosterone concentration (PAC) in community based population [ 21 , 22 ] by considering sex, since several studies have observed gender differences in levels and or regulators of aldosterone between men and women [ 5 ].…”

“…As described previously [ 21 , 22 ], we used a multi-stage stratified sampling method to enroll study participants aged ≥ 18 years. At the first stage, Emin county was divided into three settings as urban, agricultural and stock-raising areas [ 21 ].…”

Risk factors affecting the sleep quality of patients on dialysis: A single-center cross-sectional study

“…Previous research has demonstrated the prevalence of poor sleep quality in various forms of hypertension, including idiopathic intracranial hypertension, metabolic syndrome-associated hypertension, and aldosterone-induced hypertension. [15][16][17][18] However, the causality between hypertension and poor sleep quality remains unclear, and further interventional studies may be required to elucidate this relationship.…”

Aldosterone Synthase Inhibition With Lorundrostat for Uncontrolled Hypertension

“…An increased global prevalence of hypertension has paralleled increasing rates of obesity . Excess aldosterone production contributes to uncontrolled BP in patients with obesity and other associated diseases, such as obstructive sleep apnea and metabolic syndrome …”

“…4 Excess aldosterone production contributes to uncontrolled BP in patients with obesity and other associated diseases, such as obstructive sleep apnea and metabolic syndrome. [5][6][7][8][9][10][11] Contemporary guidance for treatment of resistant hypertension advocates for use of mineralocorticoid receptor antagonists (MRAs) following treatment with a 3-drug regimen of a thiazide-type diuretic, a dihydropyridine calcium channel blocker, and an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. 12 However, antiandrogenicand progestogenic-related adverse effects are common barriers to wider MRA use, particularly use of spironolactone.…”