Key result
Primary aldosteronism in hypertensive patients shows ~60% OSA prevalence, linked to kidney hyperfiltration.
Why the study?
Investigating the co-occurrence of obstructive sleep apnea and primary aldosteronism is crucial for understanding their interrelation.
What is the prevalence of obstructive sleep apnea in patients with primary aldosteronism, and vice versa, among hypertensive individuals?
Meta-Analysis
What is the prevalence of obstructive sleep apnea in patients with primary aldosteronism, and vice versa, among hypertensive individuals?
There is a high prevalence of OSA (59.8%) in hypertensive patients with primary aldosteronism, which is significantly associated with kidney hyperfiltration.
Supports OSA screening in hypertensive primary aldosteronism; extends association with kidney hyperfiltration.
CONTEXT: Investigating the co-occurrence of obstructive sleep apnea (OSA) and primary aldosteronism (PA) is crucial for understanding their interrelation. OBJECTIVE: This work aimed to evaluate the prevalence of OSA in individuals diagnosed with PA and to assess the prevalence of PA within the OSA population, with a specific focus on hypertensive individuals. METHODS: An exhaustive search was performed across PubMed, Embase, CINAHL, Scopus, and Web of Science up to September 2023, without restrictions on language or publication date. Studies were selected based on their focus on the prevalence of OSA in PA patients and vice versa, specifically in hypertensive individuals. Data were extracted using standard guidelines, focusing on patient characteristics, prevalence rates, and other relevant clinical parameters. RESULTS: Proportional meta-analysis using a random-effects model revealed a 59.8% prevalence of OSA in hypertensive PA patients, with 45.4% exhibiting moderate-to-severe OSA. Meta-regression showed no significant effect of age, sex, body mass index, antihypertensive medication, systolic blood pressure, diastolic blood pressure, or serum potassium on OSA prevalence. However, a significant positive association was found with the glomerular filtration rate (GFR) (P < .001). Subgroup analysis also revealed that a hyperfiltration rate (GFR ≥ 100 mL/min per 1.73 m2) may be associated with a higher prevalence of OSA (71%, P value for interaction < .01). Among hypertensive OSA patients, 11.2% had PA. CONCLUSION: A substantial prevalence of OSA in individuals with PA was identified, demonstrating a complex interplay between these conditions in hypertensive patients. Notably, the prevalence of OSA was significantly associated with kidney hyperfiltration.
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Sheu et al. (2024) conducted a meta-analysis in Primary Aldosteronism and Obstructive Sleep Apnea. Primary Aldosteronism was evaluated on Prevalence of obstructive sleep apnea in hypertensive patients with primary aldosteronism. Hypertensive patients with primary aldosteronism had a 59.8% prevalence of obstructive sleep apnea, which was significantly associated with kidney hyperfiltration (P<0.001).
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