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. 2013 Apr;143(4):978-983.
doi: 10.1378/chest.12-0802.

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

Eduardo Pimenta  1 , Michael Stowasser  2 , Richard D Gordon  2 , Susan M Harding  3 , Michel Batlouni  4 , Bin Zhang  5 , Suzanne Oparil  6 , David A Calhoun  7
Affiliations

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

Eduardo Pimenta et al. Chest. 2013 Apr.

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.

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Comment in

  • Obstructive sleep apnea and sodium intake: what is the mechanism?
    Mirrakhimov AE, Mirrakhimov EM. Mirrakhimov AE, et al. Chest. 2013 Aug;144(2):719-720. doi: 10.1378/chest.13-0925. Chest. 2013. PMID: 23918136 No abstract available.
  • Response.
    Pimenta E, Calhoun DA. Pimenta E, et al. Chest. 2013 Aug;144(2):720. doi: 10.1378/chest.13-0969. Chest. 2013. PMID: 23918137 Free PMC article. No abstract available.

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