[BP.05.01] THE CLINICAL CHARACTERISTICS OF PATIENTS WITH PRIMARY ALDOSTERONISM COMPLICATED WITH OBSTRUCTIVE SLEEP APNEA - HYPOPNEA SYNDROME. (September 2017) - Ge, Q.
Abstract : Objective: This study aims to compare the differences of aldosterone, renin level and target organ damage in patients with primary aldosteronism complicated with or without OSAHS. Design and method: This study retrospectively analyzed patients who were diagnosed with PA in the Department of Hypertension, Ruijin Hospital during the period of 2010.1–2015.11. The cut-off value of plasma aldosterone to renin ratio (ARR) greater than 240 [ng / dl] / [ng / ml / h] was used to screen PA candidates, and plasma aldosterone greater than 60 ng / ml after saline infusion test was used as e PA confirmation criteria. According to the polysomnography, OSAHS was diagnosed with symptoms of apnea hypopnea index (AHI) > = 5 times / hour accompanied by nocturnal snoring or wakefulness or daytime sleepiness. Results: This study included 677 patients with PA, among them, 68 patients complicated with OSAHS. The prevalence of PA complicated OSAHS is 10.04%. Our study shows that PA with OSAHS group had significantly higher diastolic blood pressure (DBP), body mass index (BMI), triglyceride and low density lipoprotein level, left ventricular end-diastolic diameter and carotid intima-media thickness, and lower estimated glomerular filtration rate (eGFR) than those of patients without OSAHS group. In addition, the supine plasma renin activity of patients with PA and OSAHS was significantly higher, but plasma aldosterone level and ARR were significantly lower than those without OSAHS. When matched with age, sex, duration of hypertension and BMI, these two groups had no significant differences on plasma and urinary aldosterone levels, but the group with PA and OSAHS still had higher supine plasma renin activity and lower ARR and eGFR than the group without OSAHS. Furthermore, we found the lowest nocturnal oxyhemoglobin saturation was negatively correlated with BMI in OSAHS group(r = -0.318, P = 0.018). Conclusions: Patients with both PA and OSAHS had higher BMI, DBP, renin level and lower ARR and eGFR than those of patients without OSAHS. The difference of eGFR remained even after matching with age, BMI and duration of hypertension. OSAHS screening is therefore important in patients with PA. Figure. No caption available.