The Clinical Characteristics Of Patients With Primary Aldosteronism Complicated With Obstructive Sleep Apnea-hypopnea Syndrome

Objective:This study aims to compare the differences of aldosterone,renin level and target organ damage in patients with primary aldosteronism(PA)complicated with or without obstructive sleep apnea-hypopnea syndrome(OSAS).Methods: Clinical data of patients diagnosed with PA in the department of Hypertension,Ruijin Hospital between 2010 and 2015 were analyzed retrospectively.Patients were divided into PA with OSAS group and PA group according to the results of polysomnography(PSG).Results:68 patients with PA complicated with OSAS(10%)and 609 patients with only PA were recruited in this study.Compared with simple PA group,PA with OSAS group showed higher proportion of male patients(P<0.05),higher body mass index(BMI)(P<0.001),diastolic blood pressure(DBP)(P<0.01),higher triglyceride,total cholesterol,low density lipoprotein levels,carotid intima-media thickness(P<0.05),and lower high density lipoprotein level as well as estimated glomerular filtration rate(e GFR)(P<0.05).In addition,patients with PA and OSAS presented higher plasma renin activity level(P<0.001),lower supine plasma aldosterone level(P<0.01),and ARR(P<0.001)than those patients without OSAS.When matched with age,sex,duration of hypertension and BMI,the PA with OSAS group still had higher total cholesterol level,plasma renin activity(P<0.01)and lower ARR(P<0.01)and e GFR(P<0.05)than the group without OSAS.Furthermore,we found that the minimum nocturnal oxygen saturation was negatively correlated with BMI in PA with OSAS group(r=-0.318,P=0.018);However,plasma aldosterone level,renin level,ARR and e GFR had no significantly correlation with neither AHI nor the minimum nocturnal oxygen saturation.Conclusion: Patients with both PA and OSAS had higher BMI,DBP,dyslipidemia,renin level and lower ARR and e GFR than those patients without OSAS.The difference of e GFR remained even after matching with age,sex,BMI,and duration of hypertension.Patients with OSAS should be underwent PA workup.