Document Detail

Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism.
MedLine Citation:
PMID:  23288434     Owner:  NLM     Status:  MEDLINE    
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.
Eduardo Pimenta; Michael Stowasser; Richard D Gordon; Susan M Harding; Michel Batlouni; Bin Zhang; Suzanne Oparil; David A Calhoun
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  143     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-07-08     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  978-83     Citation Subset:  AIM; IM    
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MeSH Terms
Aldosterone / urine
Blood Pressure / physiology
Cross-Sectional Studies
Hyperaldosteronism / epidemiology*,  urine
Hypertension / epidemiology*,  urine
Middle Aged
Prospective Studies
Severity of Illness Index*
Sleep Apnea, Obstructive / diagnosis*,  epidemiology*,  urine
Sodium / urine
Sodium, Dietary / adverse effects*
Grant Support
Reg. No./Substance:
0/Sodium, Dietary; 4964P6T9RB/Aldosterone; 9NEZ333N27/Sodium
Comment In:
Chest. 2013 Aug;144(2):720   [PMID:  23918137 ]
Chest. 2013 Aug;144(2):719-20   [PMID:  23918136 ]

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