Primary Aldosteronism and Obstructive Sleep Apnea: A Cross-Sectional Multi-Ethnic Study

Area of Science:

• Endocrinology
• Sleep Medicine
• Cardiology

Background:

• The association between primary aldosteronism (PA) and obstructive sleep apnea (OSA) remains debated.
• Current guidelines recommend screening all hypertensive patients with OSA for PA.

Purpose of the Study:

• To evaluate the prevalence of PA in OSA patients.
• To determine the prevalence of OSA in unselected PA patients.

Main Methods:

• A multicenter, multiethnic, cross-sectional study.
• Screened 203 OSA patients for PA and 207 PA patients for OSA using cardiorespiratory polygraphy.

Main Results:

• PA prevalence in OSA patients was 8.9% (11.8% in whites, 5.9% in Chinese).
• PA prevalence dropped to 1.5% in OSA patients without other PA indications.
• OSA prevalence in PA patients was 67.6%, consistent across ethnicities.
• Aldosterone levels correlated with OSA severity in white PA patients.

Conclusions:

• Patients with OSA are not at high risk for PA.
• Aldosterone may influence OSA severity in white patients with hyperaldosteronism.
• The study challenges universal PA screening recommendations for all OSA patients.