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

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.

• Authors: Eduardo Pimenta, Michael Stowasser, Richard D Gordon, Susan M Harding, Michel Batlouni, Bin Zhang, Suzanne Oparil, David A Calhoun
• Journal: Chest (Chest) Vol. 143 Issue 4 Pg. 978-983 (Apr 2013) ISSN: 1931-3543 [Electronic] United States
• PMID: 23288434 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Sodium, Dietary
• Aldosterone
• Sodium

Topics

• Aldosterone (urine)
• Blood Pressure (physiology)
• Comorbidity
• Cross-Sectional Studies
• Female
• Humans
• Hyperaldosteronism (epidemiology, urine)
• Hypertension (epidemiology, urine)
• Male
• Middle Aged
• Polysomnography
• Prevalence
• Prospective Studies
• Severity of Illness Index
• Sleep Apnea, Obstructive (diagnosis, epidemiology, urine)
• Sodium (urine)
• Sodium, Dietary (adverse effects)