Biochemical profile of severe obstructive sleep apnea can mimic primary aldosteronism
Bibliographic record
Abstract
New reports suggest a high prevalence of primary aldosteronism (PA) in patients with essential hypertension, especially in those whose blood pressure (BP) is difficult to control. We recently demonstrated that obstructive sleep apnea (OSA) is highly prevalent in refractory hypertension (RH). In that study ambulatory sitting plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were measured in patients taking BP-lowering drugs as a screening test for PA on a free-choice diet. None had definite PA, and no confirmatory tests were done. In this report we ascertained the relationship between apnea-hypopnea index (AHI), an indicator of OSA severity, and PAC, PRA and the PAC/PRA ratio (ARR). Moderate to severely hypertensive patients (sitting clinic BP of 155/90 on a mean of 3.1 antihypertensive drugs) were classified as having no or mild, moderate and severe OSA, based on an AHI of <15, 15–29, ≥30 respectively from overnight polysomnography. The 24 men and 22 women studied had a mean age of 57.4 y, body mass index (BMI) of 33.3 kg/m2 and AHI of 24.3 events/h. The frequency of PAC ≥15 ng/100mL was 10.9%, and ARR ≥25, 13.0%. Results, categorized by OSA severity and expressed as mean ± standard deviation, are presented in Table. Additionally, AHI was a significant predictor of ARR (p = 0.026). Taken together, these findings suggest that severe OSA is associated with a biochemical profile that can suggest PA. A more systematic study is now needed to explore these relationships. p = 0.021 (unadjusted) or 0.037 (adjusted for BMI) in ANOVA. p = 0.021 (unadjusted) or 0.037 (adjusted for BMI) in ANOVA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".