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

Hypertension Research volume 46, pages 1385–1394 (2023)Cite this article

A Comment to this article was published on 09 May 2023

Abstract

Obstructive sleep apnea (OSA) and primary aldosteronism (PA) often coexist in hypertension, whereas whether hypertensive patients with OSA should be screened for PA is controversial and whether gender, age, obesity and OSA severity should be considered is unexplored. We explored cross-sectionally prevalence and associated factors of PA in co-existent hypertension and OSA by considering gender, age, obesity and OSA severity. OSA was defined as AHI ≥5 events/h. PA diagnosis was defined, based on the 2016 Endocrine Society Guideline. We included 3306 patients with hypertension (2564 with OSA). PA prevalence was significantly higher in hypertensives with OSA than in those without OSA (13.2 vs 10.0%, P = 0.018). In gender-specific analysis, PA prevalence was significantly higher in hypertensive men with OSA, compared to non-OSA ones (13.8 vs 7.7%, P = 0.001). In further analysis, PA prevalence was significantly higher in hypertensive men with OSA aged <45 years (12.7 vs 7.0%), 45–59 years (16.6 vs 8.5%), and with overweight and obesity (14.1 vs 7.1%) than did their counterparts (P < 0.05). For OSA severity, men participants showed increased PA prevalence from non to moderate OSA and a decrease in the severe OSA group (7.7 vs 12.9 vs 15.1 vs 13.7%, P = 0.008). Young and middle age, moderate-severe OSA, weight, and blood pressure showed a positive independent association with PA presence in logistic regression. In conclusion, PA is prevalent in co-existent hypertension and OSA, indicating the need for PA screening. Studies are needed for women, older and lean population due to the smaller samples in this study.

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Acknowledgements

NL provided the idea, obtained the fund support, participated in the design, gave critical advice in data analysis, interpretation, and in writing. MH designed the study, collected and analyzed the data, and wrote the paper. XA, LG, ML, QL, MW, JH, NM, GD, WY, LY and QZ participated in the design, collected the data, gave data advice in data analysis and interpretation, and in writing.

Funding

This study was supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2020-RW330-002).

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Authors and Affiliations

  1. Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region, Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China

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

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  1. Mulalibieke Heizhati
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Correspondence to Nanfang Li.

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Heizhati, M., Aierken, X., Gan, L. et al. Prevalence of primary aldosteronism in patients with concomitant hypertension and obstructive sleep apnea, baseline data of a cohort. Hypertens Res 46, 1385–1394 (2023). https://doi.org/10.1038/s41440-023-01226-w

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