Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism

Pimenta, Eduardo, Stowasser, Michael, Gordon, Richard D., Harding, Susan M., Batlouni, Michel, Zhang, Bin, Oparil, Suzanne and Calhoun, David A. (2013) Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism. Chest, 143 4: 978-983. doi:10.1378/chest.12-0802


Author Pimenta, Eduardo
Stowasser, Michael
Gordon, Richard D.
Harding, Susan M.
Batlouni, Michel
Zhang, Bin
Oparil, Suzanne
Calhoun, David A.
Title Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism
Journal name Chest   Check publisher's open access policy
ISSN 0012-3692
1931-3543
Publication date 2013-04-01
Year available 2013
Sub-type Article (original research)
DOI 10.1378/chest.12-0802
Volume 143
Issue 4
Start page 978
End page 983
Total pages 6
Place of publication Northbrook, IL, United States
Publisher American College of Chest Physicians
Collection year 2014
Language eng
Formatted abstract
Background: Obstructive sleep apnea (OSA) is a strong and independent risk factor for the development of hypertension, particularly resistant hypertension, and cardiovascular diseases. Patients with resistant hypertension have a high prevalence of OSA in association with elevated aldosterone levels, high salt intake, and salt-sensitive BP. The objective of this study was to determine whether dietary salt and aldosterone are associated with severity of OSA in patients with resistant hypertension.

Methods
: Ninety-seven patients with resistant hypertension were prospectively evaluated by overnight polysomnography and 24-h urinary sodium and aldosterone levels while maintaining their usual diet. Hyperaldosteronism was defined as a plasma renin activity of < 1 ng/mL/h and urinary aldosterone level of ≥ 12 μg/24 h.

Results
: Overall, patients’ mean clinic BP was 156.3 ± 22.4/88.9 ± 13.3 mm Hg while taking an average of 4.3 ± 1.1 antihypertensive medications. Prevalence of OSA was 77.3%. Twenty-eight (28.9%) patients had hyperaldosteronism. Urinary sodium level was an independent predictor of severity of OSA only in patients with hyperaldosteronism.     

Conclusions
: The findings suggest that dietary salt is related to the severity of OSA in patients with resistant hypertension and hyperaldosteronism. The results support dietary salt restriction as a treatment strategy for reduction of OSA severity in these patients.

Keyword High blood pressure
Professional education committee
Renin activity ratio
Primary aldosteronism
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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