Prevalence of primary aldosteronism in patients with concomitant hypertension and obstructive sleep apnea, baseline data of a cohort

Heizhati, Mulalibieke; Aierken, Xiayire; Gan, Lin; Lin, Mengyue; Luo, Qian; Wang, Menghui; Hu, Junli; Maimaiti, Nuerguli; Duiyimuhan, Gulinuer; Yang, Wenbo; Yao, Ling; Zhu, Qing; Li, Nanfang

doi:10.1038/s41440-023-01226-w

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…The relationship between sex and the RAAS has been inconsistent across various studies. Visceral obesity and insulin resistance have been associated with an elevated PAC in normotensive women[6], while male PA patients are more prone to obesity and obesity-related metabolic disorders [7][8][9][10]. This intricate connection between aldosterone and visceral obesity involves adipose tissue-secreted factors stimulating aldosterone production.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Clinical Manifestations and Serum CXCR4/CXCL12 Levels in Patients with Type 2 Diabetes and Primary Aldosteronism

liu,

Zhou,

et al. 2024

Preprint

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Type 2 diabetes mellitus (T2DM) and hypertension are prevalent chronic diseases in modern society. Primary hyperaldosteronism (PA) is the most common cause of secondary hypertension. Our study examined the clinical characteristics of T2DM patients afflicted with PA. We enrolled a total of 213 T2DM patients with hypertension and observed a 22.1% prevalence of PA within this group. Sex disparities in clinical presentations were observed. Among male PA patients, the incidence of obesity significantly exceeded that of the essential hypertension (EH) group (40% vs. 4.5%, χ2 = 4.172, p = 0.041), with the plasma aldosterone concentration (PAC) demonstrating a positive correlation with body mass index (BMI) (correlation coefficient = 0.318, p = 0.001). In contrast, among female PA patients, the prevalence of proteinuria was notably greater than that in the EH group (54.5% vs. 24.7%, p < 0.05), and the PAC was positively correlated with proteinuria (correlation coefficient = 0.213, p = 0.032). Significant sex differences emerged in the serum concentrations of brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), C-X-C motif chemokine receptor 4 (CXCR4), C-X-C motif chemokine ligand 12 (CXCL12), adiponectin, and leptin. The serum levels of BNP, ANP, CXCR4, CXCL12, and leptin were significantly correlated with BMI. In female patients, the PAC was significantly positively correlated with CXCR4 (correlation coefficient = 0.322, p = 0.004) and CXCL12 (correlation coefficient = 0.248, p = 0.029). Our findings highlight sex-specific differences in the clinical manifestations of T2DM patients with PA. Notably, the serum BNP, ANP, leptin, adiponectin, CXCR4, and CXCL12 levels exhibited significant sex differences and correlated significantly with BMI. In female patients, the PAC was positively correlated with CXCR4 and CXCL12 levels.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in Clinical Manifestations and Serum CXCR4/CXCL12 Levels in Patients with Type 2 Diabetes and Primary Aldosteronism

liu,

Zhou,

et al. 2024

Preprint

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“…Intermittent hypoxia increases serum concentration of renin and aldosterone in animal models ( 60 ), and hormones of the renin-angiotensin-aldosterone system are elevated in people with OSA independent of resistant hypertension and obesity ( 59 ). Patients with primary aldosteronism have an increased frequency of OSA ( 61 ), which is more severe in those with higher serum aldosterone concentrations ( 62 ) and that improves with treatment of the primary aldosteronism ( 63 ). The likely mechanism is an increase in fluid shifts at night affecting the mass and function of upper airway muscles ( 63 ).…”

Section: Pathophysiology and Associations Of Osa With Other Disordersmentioning

confidence: 99%

Approach the Patient With Obstructive Sleep Apnea and Obesity

Meyer,

Wittert

2023

The Journal of Clinical Endocrinology &Amp; Metabolism

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Obstructive sleep apnoea (OSA) and obesity are highly prevalent and bidirectionally associated. OSA is however underrecognized, particularly in women. By mechanisms that overlap with those of obesity, OSA increases the risk of developing, or having poor outcomes from, comorbid chronic disorders and impairs quality of life. Using two illustrative cases we discuss the relationships between OSA and obesity with type 2 diabetes, dyslipidemia, cardiovascular disease, cognitive disturbance, mood disorders, lower urinary tract symptoms, sexual function, and reproductive disorders. The differences in OSA between men and women, the phenotypic variability of OSA, and co-morbid sleep disorders are highlighted. When the probability of OSA is high due to consistent symptoms, comorbidities, or both, a diagnostic sleep study is advisable. Continuous positive airway pressure or mandibular advancement splints improve symptoms. Benefits for comorbidities are variable depending on nightly duration of use. By contrast weight loss and optimization of lifestyle behaviors are consistently beneficial.

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“…28 Similarly, PA is common in OSA due to the hypoxia-mediated rise in plasma endothelin-1 levels increasing the aldosterone secretion. 29 As the renin and PAC are measured using varied assays, and the results are available in different units from different laboratories, it is not possible to establish a rigid diagnostic threshold for ARR. The performance of ARR, especially the sensitivity, differed markedly based on the study population and diagnostic threshold.…”

Section: Primary Aldosteronismmentioning

confidence: 99%

Endocrine Hypertension: The Urgent Need for Greater Global Awareness

Fernandez,

Nagendra,

Alkhalifah

et al. 2023

touchREVIEWS in Endocrinology

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Hypertension affects about 1.28 billion adults globally, and significantly increases the risk of chronic morbidity and mortality among sufferers. About 15% of these individuals have secondary hypertension, the majority of whom have dysfunction of one or more endocrine systems as the cause of hypertension. Although adrenal disorders are often identified as the cause of endocrine hypertension, extra-adrenal disease and pituitary disorders also can cause the disease. Timely diagnosis is of paramount importance, because of the potential for a surgical cure or optimal disease control with pharmacotherapy to prevent hypertensive complications. Even with its relatively high prevalence compared with many other chronic illnesses, the diagnosis of endocrine hypertension is often delayed or never made because of poor awareness about the disease among physicians. This review attempts to provide an overview of the disease, with some practical aspects of diagnosis and management of a few of the important disorders causing endocrine hypertension.

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Prevalence of primary aldosteronism in patients with concomitant hypertension and obstructive sleep apnea, baseline data of a cohort

Cited by 8 publications

References 33 publications

Sex Differences in Clinical Manifestations and Serum CXCR4/CXCL12 Levels in Patients with Type 2 Diabetes and Primary Aldosteronism

Sex Differences in Clinical Manifestations and Serum CXCR4/CXCL12 Levels in Patients with Type 2 Diabetes and Primary Aldosteronism

Approach the Patient With Obstructive Sleep Apnea and Obesity

Endocrine Hypertension: The Urgent Need for Greater Global Awareness

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