Frontiers in Endocrinology (Jan 2023)

Association of objective and subjective parameters of obstructive sleep apnea with plasma aldosterone concentration in 2,066 hypertensive and 25,368 general population

  • Hui Wang,
  • Mulalibieke Heizhati,
  • Nanfang Li,
  • Lin Gan,
  • Mengyue Lin,
  • Wenbo Yang,
  • Mei Li,
  • Ling Yao,
  • Miaomiao Liu,
  • Adalaiti Maitituersun,
  • Shasha Liu,
  • Zihao Wu,
  • Zuhere Xiamili,
  • Ling Tong,
  • Yue Lin,
  • Qin Luo,
  • Jing Hong

DOI
https://doi.org/10.3389/fendo.2022.1016804
Journal volume & issue
Vol. 13

Abstract

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Study objectivesObstructive sleep apnea (OSA) severity has been suggested in aldosterone elevation in resistant hypertension, whereas it is undetermined in the rest population. We explored the association of OSA parameters with plasma aldosterone concentration (PAC) in participants with and without hypertension.MethodsWe enrolled clinically hypertensive patients with polysomnography and PAC data under no interfering agents, compared (log) PAC, and assessed the linearity of log PAC by tertiles (T1/2/3) of sleep parameters and their association using linear regression by gender and age. We enrolled participants with and without hypertension who had No-SAS scale and PAC data from the community and duplicated the observations from clinical setting considering age, gender, and presence of hypertension.ResultsOf the 2,066 clinical patients with hypertension (1,546 with OSA), men participants (n=1,412), log apnea–hypopnea index (p=0.043), apnea index (AI, p=0.010), and lowest oxygen saturation (LSaO2, p=0.013) showed significant linearity with log PAC. Log AI (B=0.04, 95%CI: 0.01,0.07, p=0.022) and log LSaO2 (B=−0.39, 95%CI: −0.78,−0.01, p=0.044) showed significant positive and negative linear associations with log PAC in regression. In community dwellers, 6,417 participants with untreated hypertension (2,642 with OSA) and 18,951 normotensive participants (3,000 with OSA) were included. Of the men participants with and without hypertension, the OSA group showed significantly higher (log) PAC than did their counterparts, and log No-SAS score showed positive association with log PAC (hypertension: B=0.072, 95%CI: 0.002,0.142, p=0.043; normotension: B=0.103, 95%CI: 0.067,0.139, p<0.001) in linear regression analysis, which were consistent in all age groups.ConclusionsOSA parameters were positively associated with PAC in normotensive and hypertensive participants, indicating that OSA may increase circulating aldosterone, especially in men.

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