title: Relationship between primary aldosteronism and obstructive sleep apnoea, metabolic abnormalities and cardiac structure in patients with resistant hypertension.
abstract: BACKGROUND
  The aim of this study was to evaluate in patients with resistant hypertension (RHTN) enrolled in the RESIST-POL study the relationship between primary aldosteronism (PA) and obstructive sleep apnoea (OSA) and their effect on metabolic abnormalities and cardiac structure.
  
  
  METHODS
  We included 204 patients (123 M, 81 F, mean age 48.4 yrs) with true RHTN, eGFR > 60 mL/min/1,73 m(2) and no known diabetes. OSA was defined as an apnoea/hypopnoea index of 15/h or more. Metabolic syndrome components were assessed. On echocardiography, left ventricular hypertrophy (LVH), concentric remodelling (RWT > 0.45), E' velocity, E/E' index and global strain (GLS) were evaluated.
  
  
  RESULTS
  PA was diagnosed in 32 patients (15.7%). OSA occurred more frequently in patients with PA (59.4 v. 42.4%; p = 0.058). Patients were divided into four groups: PA+ OSA+ , PA+ OSA-, PA-OSA+ and PA-OSA-. Newly diagnosed diabetes, impaired glucose tolerance and increased fasting glucose were most frequent in the PA+ OSA+ group compared to other groups. The presence of OSA was associated with concentric remodelling, and the presence of PA was associated with higher left ventricular mass and higher frequency of left ventricular hypertrophy. In the PA+ OSA+ and PA+ OSA- groups, the most frequent geometry patterns were concentric hypertrophy (68.4%) and eccentric hypertrophy (54.5%) respectively. E' velocity was lowest and E/E' was highest in PA+ OSA+ compared to other groups. GLS was lower in patients with OSA compared to those without OSA.
  
  
  CONCLUSIONS
  Both metabolic abnormalities and target organ damage are more pronounced in patients with RHTN, PA and OSA. OSA and PA influence differently left ventricular geometry.
authors.affiliation: a.prejbisz@ikard.pl.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Prejbisz
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Florczak
authors.forename: Anna
authors.initials: A
authors.lastname: Klisiewicz
authors.forename: Piotr
authors.initials: P
authors.lastname: Dobrowolski
authors.forename: Hanna
authors.initials: H
authors.lastname: Janaszek-Sitkowska
authors.forename: Przemysław
authors.initials: P
authors.lastname: Bieleń
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Szwench-Pietrasz
authors.forename: Ewa
authors.initials: E
authors.lastname: Warchoł-Celińska
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kołodziejczyk-Kruk
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Janas
authors.forename: Marek
authors.initials: M
authors.lastname: Kabat
authors.forename: Jacek
authors.initials: J
authors.lastname: Imiela
authors.forename: Paweł
authors.initials: P
authors.lastname: Sliwiński
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
mesh_terms: D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging / Q000453:epidemiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*