Increased Dietary Sodium Is Related to Severity of Obstructive Sleep Apnea in Patients With Resistant Hypertension and Hyperaldosteronism

Chest (Impact Factor: 7.13). 01/2013; 143(4). DOI: 10.1378/chest.12-0802
Source: PubMed

ABSTRACT 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-sensitivity of blood pressure. OBJECTIVES: Determine if 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-hour urinary sodium excretion (UNa) and aldosterone while ingesting their usual diet. Hyperaldosteronism was defined as PRA < 1 ng/mL/hr and UAldo ≥ 12 µg/24-hr. RESULTS: Overall, the mean clinic blood pressure (BP) was 156.3±22.4/88.9±13.3 mm Hg on an average 4.3±1.1 antihypertensive medications. Prevalence of OSA was 77.3%. Twenty-eight (28.9%) of patients were diagnosed with hyperaldosteronism. UNa was an independent predictor of severity of OSA only in patients with hyperaldosteronism. CONCLUSIONS: The current findings suggest that dietary salt is related to the severity of OSA in patients with resistant hypertension and hyperaldosteronism. Our results support dietary salt restriction as a treatment strategy for reduction of OSA severity in these patients.

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