Department of Cardiology, Shenzhen Sun Yat-sen Cardiovascular Hospital, Shenzhen, China.
Department of Cardiology, the Fifth subsidiary Sun Yat-sen University Hospital, Zhuhai, China.
Sci Rep. 2017 Mar 22;7:45241. doi: 10.1038/srep45241.
The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis. A total of 534 patients with resistant hypertension were enrolled and mean age was 57 ± 11 years. Overall, mean number of AHI was 21.7 ± 9.6 and nearly 92.3% of resistant hypertensive patients had obstructive sleep apnea (OSA). Mean PAC and 24 h-urine aldosterone level was 12.4 ± 6.3 ng/dL and 13.1 ± 6.8 ug, respectively. Compared with other groups, participants in the severe OSA group (AHI ≥ 30) had significantly higher PAC and 24 h-urine aldosterone level. Multiple linear regression analysis showed that PAC and 24 h-urine aldosterone levels were positively associated with AHI, while spironolactone was negatively associated with AHI, independent of age, gender, body mass index, smoking, plasma renin activity and diuretics. OSA is highly prevalent in patients with resistant hypertension and both PAC and 24 h-urine aldosterone level are significantly associated with AHI.
本研究旨在探讨醛固酮过多与难治性高血压患者呼吸暂停低通气指数（AHI）的关系。纳入难治性高血压患者，收集其基线特征，包括血浆醛固酮浓度（PAC）和 24 小时尿醛固酮水平，并根据多导睡眠图评估的不同 AHI 程度进行组间比较。然后通过单因素和多元线性回归分析评估关键变量与 AHI 的相关性。共纳入 534 例难治性高血压患者，平均年龄为 57±11 岁。总体而言，AHI 的平均值为 21.7±9.6，近 92.3%的难治性高血压患者患有阻塞性睡眠呼吸暂停（OSA）。平均 PAC 和 24 小时尿醛固酮水平分别为 12.4±6.3ng/dL 和 13.1±6.8μg。与其他组相比，严重 OSA 组（AHI≥30）的 PAC 和 24 小时尿醛固酮水平显著升高。多元线性回归分析显示，PAC 和 24 小时尿醛固酮水平与 AHI 呈正相关，而螺内酯与 AHI 呈负相关，与年龄、性别、体重指数、吸烟、血浆肾素活性和利尿剂无关。OSA 在难治性高血压患者中非常普遍，PAC 和 24 小时尿醛固酮水平与 AHI 显著相关。
