Primary Aldosteronism and Obstructive Sleep Apnea: Casual Association
                    or Pathophysiological Link?

Alessio Pecori; Fabrizio Buffolo; Jacopo Pieroni; Vittorio Forestiero; Elisa Sconfienza; Franco Veglio; Paolo Mulatero; Silvia Monticone

doi:10.1055/a-1133-7255

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2020; 52(06): 366-372
DOI: 10.1055/a-1133-7255

Review

Primary Aldosteronism and Obstructive Sleep Apnea: Casual Association or Pathophysiological Link?

Alessio Pecori

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Fabrizio Buffolo

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Jacopo Pieroni

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Vittorio Forestiero

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Elisa Sconfienza

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Franco Veglio

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Paolo Mulatero

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

,

Silvia Monticone

¹Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy

› Author Affiliations

Abstract

The coexistence of aldosterone oversecretion and obstructive sleep apnea is frequently observed, especially in patients with resistant hypertension, obesity, and metabolic syndrome. Since aldosterone excess and sleep apnea are both independently associated with an increased risk of cardiovascular disease, to investigate whether their coexistence might be attributed to common predisposing conditions, such as metabolic disorders, or to an actual pathophysiological interconnection appears of great importance. Fluid overload and metabolic abnormalities relating to aldosterone oversecretion may be implicated in obstructive sleep apnea development. Nocturnal intermittent hypoxia may in turn exacerbate renin-angiotensin-aldosterone system activity, thus leading to hyperaldosteronism. Furthermore, fat tissue excess and adipocyte secretory products might predispose to both sleep apnea and aldosterone oversecretion in subjects with obesity. Consistent with these evidences, obstructive sleep apnea frequently affects patients with primary aldosteronism. Conversely, whether primary aldosteronism is more prevalent in individuals affected by obstructive sleep apnea compared to the general population remains controversial.

Key words

aldosterone - sleep disorders - obesity - metabolic syndrome - apnea-hypopnea index - leptin

Full Text

References

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