Table 1.
The prevalence of OSA in PA patients.
| Author | Study design | Nation | Subjects | Assessment of PA | Assessment of OSA | Prevalence of OSA |
|---|---|---|---|---|---|---|
| Nakamura (11) | Cross-sectional | Japan | 71 PA | Screening test (ARR > 20 ng/dl: ng/ml/h) and confirmatory test including CCT (ARR ≥ 20), FUT (PRA < 2.0 ng/ml/h), and SIT (aldosterone level ≥ 6.0 ng/dl). PA was diagnosed if ≥1 of the 3 tests were positive. | Smart Watch PMP-300E (REI ≥ 15 or REI ≥ 5 together with symptoms) | 55% |
| Li (12) | Retrospective | China | 677 PA | Screening test (ARR > 24 ng/dl: ng/ml/h) and confirmatory test (SIT: aldosterone level ≥ 6.0 ng/dl) | PSG (used only in snoring patients with PA) (AHI ≥ 5) | 10% |
| Buffolo (13) | Cross-sectional, multiethnic, multicenter | Europe | 104 PA | PA was diagnosed according to the 2016 ES guideline. Different centers have different standards for the screening test and confirmatory test. | Cardiorespiratory polygraphy (AHI ≥ 5) | 64.40% |
| China | 100 PA | Same as above | Same as above | 70% | ||
| Wang (14) | Cross-sectional study | China | 321 PA | A suppressed PRA (<1.0 μg/L/h) and an elevated aldosterone level (>12 ng/L) or an elevated ARR (>20 ng/dl: ng/ml/h) and a confirmation test by saline infusion test (aldosterone level was >5 ng/dl) | All patients suspicious of OSA underwent full-night PSG (AHI ≥5) | 45.80% |
| Prejbisz (15) | Cross-sectional | Poland | 32 PA and 172 non-PA amid 204 RHTN | screening test (ARR > 30 ng/dl: ng/ml/h, PAC > 15 ng/dl) and confirming test (CCT: aldosterone level fails to decrease by more than 30%) | All patients irrespective of the symptoms of OSA were evaluated by PSG (AHI ≥ 15) | 59.4% in PA; 42.4% in non-PA, P = 0.058 |
| Sim (16) a | Retrospective | USA | 3,428 HTN (575 had HA | HA was defined as ARR >30 (ng/dl: ng/ml/h) and PAC >20 ng/dl or ARR >50 | Sleep apnea was defined by ICD-9 coding or procedural coding for dispensation of positive airway devices. | 18% in HA vs. 9% in non-HA (P<0.001) |
OSA, obstructive sleep apnea; HTN, hypertension; RHTN, resistant hypertension; PA, primary aldosteronism; HA, hyperaldosteronism; ESS, Epworth Sleepiness Scale; PSG, polysomnography; AHI, apnea–hypopnea index; PAC, plasma aldosterone concentration; PRA, plasma renin activity; ARR, aldosterone-to-renin ratio; UAldo, urine aldosterone level; CCT, the captopril challenge test; FUT, the furosemide upright test; SIT, the saline infusion test; ICD-9, International Classification of Disease, Ninth Revision.
a
This retrospective study did not have PA confirmed.