Correlation of Obstructive Sleep Apnea and Aldosterone Levels in Patients with Primary Hyperaldosteronism

Obstructive sleep apnea (OSA) has gained research interest due to its coexistence with primary hyperaldosteronism and hypertension. Elevated aldosterone levels have been found to be independently associated with the severity of obstructive sleep apnea, especially in those with resistant hypertension. The combined impact of sleep apnea and primary hyperaldosteronism on blood pressure regulation has turned attention to this subject. In this analysis, we have included English language peer-reviewed, electronically published articles from 2019 till 2024 which determine the impact of obstructive sleep apnea and blood pressure on aldosteronism from various databases like PubMed, Google Scholar, and Scopus. The sample sizes in pooled data range from 20 to 150 participants. The data were pooled using the random-effects model and to calculate pooled prevalence rates and 95% confidence intervals (CIs). Further analyzed with the fixed-effects method to guarantee the strength of the model. Unpublished research and gray literature have been avoided which in turn may have resulted in publication bias. The severity of OSA is positively associated with aldosterone excess and elevated blood pressure. Continuous positive airway pressure (CPAP) has strong potential to improve aldosterone levels and blood pressure in patients who have primary hyperaldosteronism and obstructive sleep apnea. Interventions that decrease the levels of aldosterone, such as a competitive aldosterone receptor antagonist reduces the severity of OSA. The prevalence of sleep apnea in patients with primary hyperaldosteronism and resistant hypertension has shown that addressing both OSA and aldosterone levels is essential for effective management of hypertension in this population.