Spironolactone In The Treatment Effect Of Primary Aldosteronism With Obstructive Sleep Apnea Syndrome

Objectives It has been suggested that spironolactone can reduce the severity of obstructive sleep apnea(OSA)in patients with resistant hypertension(RH).While primary aldosteronism(PA)combined with OSAS patient who account for a large proportion of patients with resistant hypertension.To explore whether spironolactone can improve the severity OSA and blood pressure(BP)in patients with PA and OSAS.Methods Research included patients admitted to the Department of Hypertension,Xinjiang Uygur Autonomous Region People's Hospital from June 2009 to September2013,were diagnosed as PA with OSAS after polysomnography,PA screening and saline infusion test.A total of 204 patients were treated with spironolactone(40mg/day).A total of 40 patients were finally admitted to PSG and ambulatory blood pressure for the second admission.The differences between PSG examination and ambulatory blood pressure before and after spironolactone treatment in these 40 patients were retrospectively analyzed.According to the severity of OSA,it can be divided into 12 cases of mild OSA group(5?AHI <15),12 cases of moderate OSA group(15?AHI <30),and 16 cases of severe OSA group(AHI?30).Results Before and after spironolactone treatment,mild OSA group(AHI: 9.0 ± 2.9vs.23.0 ± 15.4,P <0.05),moderate OSA group(AHI: 22.6 ± 3.5 vs.16.6 ± 10.5,P<0.05,HI: 15.7 ± 6.6 vs.9.7 ± 4.9,P <0.01),severe OSA group(AHI: 54.0 ± 18.8 vs.44.6 ± 23.4,P <0.05).Within 2 years of spironolactone treatment,AHI decreased(33.7± 22.8 VS.26.7 ± 19.2 P = 0.038),all-day systolic blood pressure(136.6 ± 12.0 VS.123.9 ± 10.4,P = 0.003),and all-day diastolic blood pressure(89.4 ± 8.7 VS.81.5 ± 8.6,P = 0.001),daytime systolic blood pressure(138.5 ± 12.5 VS.128.1 ± 11.9,P = 0.003),daytime diastolic blood pressure(87.7 ± 9.1VS.84.0 ± 8.5 P = 0.038),and nighttimesystolic blood pressure(129.9 ± 13.8VS.117.0 ± 14.0,P = 0.003),nocturnal diastolic blood pressure(84.9 ± 8.8 VS.78.4 ± 9.7,P = 0.005),meanwhile,neck circumference,weight,and BMI decreased significantly,and the differences were statistically significant.Spironolactone treatment for more than 2 years,AHI and blood pressure did not improve significantly before and after treatment.Conclusion Spironolactone treatment can reduce the severity of OSA and the average blood pressure of PA patients with moderate or severe OSAS,and the effect of spironolactone treatment is obvious within 2 years.