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

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

doi:10.1055/a-1133-7255

Cited by 18 publications

(12 citation statements)

References 91 publications

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“…In summary, obesity itself was associated with an inflammatory imbalance, primary hyper-aldosteronism and a vascular dysfunction, even in not sleep-deprived patients [4,27] Thus, the sympathetic overactivity, the pro-inflammatory status, and the impaired peripheral vasodilatory response induced by a sleep insufficiency could be an additive burden to increase the cardiovascular risk of population with obesity [22].…”

Section: Inflammation Autonomic Nervous System and Vascular Responsementioning

confidence: 95%

“…Sleep disturbances are related to an increased renin-angiotensinaldosterone system stimulation and to aldosterone over-secretion, that may lead hypertension and increased cardiovascular risk [27]. For instance, patients with OSAS present higher levels of angiotensin II and aldosterone as compared to their healthy controls matched by body mass [28].…”

Section: Inflammation Autonomic Nervous System and Vascular Responsementioning

confidence: 99%

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Obesity and sleep disturbances: The “chicken or the egg” question

Rodrigues

Fiorelli

Furlan

et al. 2021

European Journal of Internal Medicine

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Obesity and sleep disturbances are common conditions in modern societies and accumulating evidence support a close bidirectional causal relationship between these two conditions. Indeed, from one side sleep loss seems to affect energy intake and expenditure through its direct effects on hormone-mediated sensations of satiety and hunger and through the influence on hedonic and psychological aspects of food consumption. Sleep deprived patients have been shown to experiment excessive daytime sleepiness, fatigue, and tiredness that, in a vicious circle, enhances physical inactivity and weight gain. On the other side, obesity is a well-known risk factor for several sleep disorders. This narrative review will discuss the main pathophysiological mechanisms that link sleep loss to obesity and metabolic syndrome with particular attention to the three most common sleep disorders (insomnia, obstructive sleep apnoea syndrome, restless leg syndrome).

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Section: Inflammation Autonomic Nervous System and Vascular Responsementioning

confidence: 95%

Section: Inflammation Autonomic Nervous System and Vascular Responsementioning

confidence: 99%

Obesity and sleep disturbances: The “chicken or the egg” question

Rodrigues

Fiorelli

Furlan

et al. 2021

European Journal of Internal Medicine

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“…PA and OSA share the same risk factor, namely obesity. Excess fat tissue exacerbates OSA and adipocyte secretory products induce aldosterone oversecretion in subjects with obesity 32 . PA generates fluid overload and metabolic abnormalities that contribute to the development of OSA.…”

Section: Endocrine Risk Factors For Osamentioning

confidence: 99%

Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship

Akset

Poppe

Kleynen

et al. 2022

Clinical Endocrinology

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Obstructive sleep apnoea (OSA) is a common disorder characterized by recurrent episodes of apnoea or hypopnea due to total or partial pharyngeal collapse and temporary upper airway obstruction during sleep. The prevalence of OSA is increasing and currently affects about 30% of men and 13% of women in Europe.Intermittent hypoxia, oxidative stress, systemic inflammation, and sleep fragmentation resulting from OSA can provoke subsequent cardiometabolic disorders. The relationships between endocrine disorders and OSA are complex and bidirectional. Indeed, several endocrine disorders are risk factors for OSA. Compared with the general population, the prevalence of OSA is increased in patients with obesity, hypothyroidism, acromegaly, Cushing syndrome, and type 1 and 2 diabetes. In some cases, treatment of the underlying endocrine disorder can improve, and occasionally cure, OSA. On the other hand, OSA can also induce endocrine disorders, particularly glucose metabolism abnormalities. Whether continuous positive airway pressure (CPAP) treatment for OSA can improve these endocrine disturbances remains unclear due to the presence of several confounding factors. In this review, we discuss the current state-of-the-art based on the review of the current medical literature for key articles focusing on the bidirectional relationship between endocrine disorders and OSA and the effects of treatment. Screening of OSA in endocrine patients is also discussed, as it remains a subject of debate.

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“…Additionally, PA is also associated with other known cardiovascular risk factors such as obstructive sleep apnea [21][22][23], obesity [24][25][26], chronic kidney disease [27,28], the metabolic syndrome, and type 2 diabetes [29][30][31][32], all of which could also contribute to the high cardiovascular risk of these patients.…”

Section: Cardiovascular Risk Associated With Primary Hyperaldosteronism (Pa)mentioning

confidence: 99%

Primary Hyperaldosteronism: When to Suspect It and How to Confirm Its Diagnosis

et al. 2022

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The definition of primary hyperaldosteronism (PA) has shifted, as progress has been made in understanding the disease. PA can be produced by unilateral or bilateral cortical adrenal hyperproduction of aldosterone, due to hyperplasia, aldosterone-secreting cell clusters, aldosterone-producing macro or micro adenoma/s, and combinations of the above, or by an aldosterone-producing carcinoma. PA is a highly prevalent disease, affecting close to 10% of the hypertensive population. However, PA is clearly underdiagnosed. The purpose of this review is to address current knowledge of PA’s clinical manifestations, as well as current methods of diagnosis. PA is associated with a higher cardiovascular morbidity and mortality than essential hypertension with similar blood pressure control. Young hypertensive patients, those with a first-degree relative with PA or ictus, and/or those with apnea/hypopnea syndrome, moderate/severe/resistant hypertension, adrenal incidentaloma, and/or hypokalemia should be screened for PA. PA can induce atrial fibrillation (AF), and those patients should also be screened for PA. We propose the use of the Captopril challenge test (CCT), oral salt loading, or intravenous salt loading for PA diagnosis, given their availability in the majority of hospital centers. CCT could be first-line, since it is safe and easy to perform.

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

Cited by 18 publications

References 91 publications

Obesity and sleep disturbances: The “chicken or the egg” question

Obesity and sleep disturbances: The “chicken or the egg” question

Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship

Primary Hyperaldosteronism: When to Suspect It and How to Confirm Its Diagnosis

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