OBJECTIVE: To investigate the prevalence and clinical characteristics of primary aldosteronism (PA) in patients with hypertension and obstructive sleep apnoea (OSA) in a newly established cohort, given inconsistencies in previous studies and intolerance to drug washout in some cases. DESIGN AND METHOD: A single-centre cross-sectional study enrolled 316 hypertensive patients diagnosed with OSA RESULTS: Among 316 patients, 41 (13.0%) were PA. The prevalence was 4.8% in OSA alone, and 50.0% in OSA with hypokalaemia. Compared to the OSA group, the OSA and PA group had a lower proportion of current smokers, a longer duration of hypertension, lower serum triglycerides, lower serum potassium, higher plasma aldosterone concentration, urinary aldosterone excretion, and lower renin. Multivariable logistic regression showed that the diagnosis of PA in OSA patients was positively associated with hypertension duration, and negatively associated with serum potassium levels and smoking. CONCLUSIONS: PA screening may be considered in patients with hypertension and OSA
however, given the relatively low prevalence in those with OSA alone, routine screening may not be cost-effective. In contrast, the presence of hypokalaemia was strongly associated with a higher prevalence of PA, suggesting that targeted screening is warranted in this subgroup.