title: Positive relationship of sleep apnea to hyperaldosteronism in an ethnically diverse population.
abstract: OBJECTIVE
  Approximately, 50-60% of patients with sleep apnea have hypertension. To explore a mechanism of this relationship, we compared its prevalence in a hypertensive population with and without hyperaldosteronism.
  
  
  METHODS
  Using the Kaiser Permanente Southern California database, hypertensive individuals who had plasma aldosterone and plasma renin activity measured between 1 January 2006 and 31 December 2007 were evaluated. Hyperaldosteronism was defined as an aldosterone : renin ratio more than 30 and plasma aldosterone more than 20 ng/dl or an aldosterone : renin ratio more than 50 (ng/dl : ng/ml per h). Hypertension was identified by International Classification of Disease, Ninth Revision (ICD-9) coding and sleep apnea was defined by ICD-9 coding or procedural coding for dispensation of positive airway devices.
  
  
  RESULTS
  Of 3428 hypertensive patients, 575 (17%) had hyperaldosteronism. Sleep apnea was present in 18% (105) with hyperaldosteronism vs. 9% (251) without hyperaldosteronism (P < 0.001). Odds ratio for sleep apnea in patients with hyperaldosteronism was 1.8 (95% confidence interval 1.3-2.6) after controlling for other sleep apnea risk factors. No ethnic group was at greater risk for sleep apnea.
  
  
  CONCLUSIONS
  The prevalence of sleep apnea in a diverse hypertensive population is increased in patients with hyperaldosteronism, even when controlling for other sleep apnea risk factors.
authors: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA. John.j.sim@kp.org
authors: John J
authors: JJ
authors: Sim
authors: Eric H
authors: EH
authors: Yan
authors: In Lu A
authors: IL
authors: Liu
authors: Scott A
authors: SA
authors: Rasgon
authors: Kamyar
authors: K
authors: Kalantar-Zadeh
authors: David A
authors: DA
authors: Calhoun
authors: Stephen F
authors: SF
authors: Derose
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006929:Hyperaldosteronism / Q000453:epidemiology* / Q000208:ethnology; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000208:ethnology; D044465:White People; D055815:Young Adult