ASSOCIATION OF SEVERE SLEEP APNOEA IN PRIMARY ALDOSTERONISM

Abstract

Objective: It is well known that sleep apnoea and primary aldosteronism are related. However, it is unclear whether aldosterone excess contributes to the severity of sleep apnoea. We investigated factors correlated with sleep apnoea in patients with primary aldosteronism: the endocrine system, including aldosterone, cardiac function, renal function, and blood pressure. Design and method: We performed a 3% oxygen saturation index with a pulse oximeter in 50 patients (54% male, 49 ± 7.3 years) diagnosed with primary aldosteronism scheduled for adrenal vein sampling in 2017-2020. 3% oxygen saturation index results were classified as mild (less than 5), moderate (5-15), or severe(15 and above) sleep apnoea. In addition, we compared aldosterone (radioimmunoassay), renin activity, aldosterone/renin activity, brain natriuretic peptide, estimated glomerular filtration rate and blood pressure at the initial visit in the severe group and other groups. Results: The severe group did not have higher aldosterone than the mild (192.7 ± 114.7 vs 238.9 ± 128.8 pg/mL, P=0.640) and moderate (192.7 ± 114.7 vs 187.5 ± 85.5 pg/mL, P=0.995) groups, and the same results were obtained for renin activity and aldosterone/renin activity. In other parameters, estimated glomerular filtration rate was not significantly different between groups, but systolic blood pressure at the initial visit in the severe group was significantly higher than in the mild (175.3±25.7 vs 144.8±18.7 mmHg, P=0.003) and moderate (175.3±25.7 vs 143.0±18.5 mmHg, P=0.003) groups. Similarly, brain natriuretic peptide in the severe group was significantly higher than in the mild (53.5±90.0 vs 12.7±8.3 pg/mL, P=0.020) and moderate (53.5±90.0 vs 10.7±11.2, P=0.014) groups. Conclusions: Our results showed that aldosterone excess did not contribute to the severity of sleep apnoea. However, severe sleep apnoea was significantly associated with elevated systolic blood pressure and brain natriuretic peptide.