Association of primary aldosteronism with severe sleep apnea and correlation between posttreatment renin activity and amount of change in respiratory event index during sleep.

STUDY

OBJECTIVES

Sleep apnea occurs more often in patients with primary aldosteronism (PA), whereas unsuppressed plasma renin activity (PRA) after treatment is associated with a lower risk of cardiovascular events. However, the relationship between PA and severe sleep apnea remains unclear, and it is not known whether PRA following treatment is associated with an apnea condition in affected patients.

METHODS

Cross-sectional relationships between PA (n = 176 affected patients) and severe sleep apnea, classified by respiratory event index obtained with use of an Apnomonitor, were examined, with the results compared to those of patients with essential hypertension (n = 418). Additionally, the correlation between PRA at follow-up and change in respiratory event index findings obtained at baseline and follow-up examinations was analyzed in 45 patients with PA, stratified based on treatment status.

RESULTS

PA was found to be significantly associated with severe sleep apnea compared to essential hypertension, even after adjustment for other clinical risk factors (odds ratio = 2.08, 95% confidence interval = 1.09-3.95, P = .025). Furthermore, posttreatment PRA showed a significantly negative correlation with change in respiratory event index from before to after treatment (r = -0.550, P = .004).

CONCLUSIONS

Compared to patients with essential hypertension, those with PA had a higher prevalence of severe sleep apnea. Furthermore, a significantly negative correlation of posttreatment PRA with a change in respiratory event index from before to after treatment was noted.

CITATION: Kidawara Y, Kadoya M, Igeta M, et al. Association of primary aldosteronism with severe sleep apnea and correlation between posttreatment renin activity and amount of change in respiratory event index during sleep. J Clin Sleep Med. 2025;21(11):1935-1942.