ArticleJournal of geriatric cardiology : JGC2016
Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensin-aldosterone system.
Article in Journal of geriatric cardiology : JGC, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
69 citing papers in PubMed, 6 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Association between obstructive sleep apnea syndrome and metabolic syndrome: a severity-stratified meta-analysis.Frontiers in medicine · 2026Pooled it
- Influence and implications of the renin-angiotensin-aldosterone system in obstructive sleep apnea: An updated systematic review and meta-analysis.Journal of sleep research · 2023Pooled it
- An umbrella review of systematic reviews and meta-analyses of observational investigations of obstructive sleep apnea and health outcomes.Sleep & breathing = Schlaf & Atmung · 2022Pooled it
- Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis.Sleep medicine · 2021Pooled it
- A systematic review of COVID-19 and obstructive sleep apnoea.Sleep medicine reviews · 2021Pooled it
- Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2018Guideline
- Adenotonsillectomy and Blood Pressure in Children With Mild Obstructive Sleep-Disordered Breathing: An Exploratory Analysis of the PATS Randomized Clinical Trial.JAMA otolaryngology-- head & neck surgery · 2025Trial
- Acute inorganic nitrate supplementation and the hypoxic ventilatory response in patients with obstructive sleep apnea.Journal of applied physiology (Bethesda, Md. : 1985) · 2021Trial
- Can primary aldosteronism and acromegaly be etiological factors in non-obese patients with obstructive sleep apnea syndrome?Journal of human hypertension · 2026Article
- Salivary Aldosterone as a Biomarker for Obstructive Sleep Apnea: Diagnostic Performance and the Moderating Role of Mean Arterial Pressure-A Cross-Sectional Study.Clocks & sleep · 2026Article
- Clinical and Biochemical Features Associated with Coexisting Primary Aldosteronism in Patients with Obstructive Sleep Apnea: A Cross-Sectional Study.Diagnostics (Basel, Switzerland) · 2026Article
- Alamandine Attenuates Hypoxia-Induced Atrial Fibrosis and Atrial Fibrillation by Involving the YAP/TAZ Pathway.Cardiovascular drugs and therapy · 2026Article
- Effects of Continuous Positive Airway Pressure for Hypertension in Patients with Obstructive Sleep Apnoea: A Structured Narrative Review of Randomised Controlled Trials.Journal of clinical medicine · 2026Review
- Broadening Primary Aldosteronism Screening: Alignment Across Contemporary Guidelines.Hypertension (Dallas, Tex. : 1979) · 2026Review
- Moderate to Severe Obstructive Sleep Apnea Is a Risk Factor for Severe COVID-19-A Nationwide Cohort Study.Journal of sleep research · 2026Article
- Obstructive sleep apnea is more closely associated with bilateral primary aldosteronism than unilateral primary aldosteronism.Journal of endocrinological investigation · 2026Article
- Severe Hypokalemia After Corticosteroid Use: A Case of Steroid-Induced Potassium Depletion.Cureus · 2026Article
- Enhanced detection of primary aldosteronism in hypertensive patients with obstructive sleep apnea using a novel diagnostic algorithm.Endocrine · 2025Article
- Article
- Incident obstructive sleep apnea in patients with primary aldosteronism following COVID-19 infection: a health global federated network analysis.Therapeutic advances in chronic disease · 2025Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObstructive sleep apnea (OSA) is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system (RAAS). We meta-analyzed the effects of OSA on plasma levels of RAAS components.
methodsFull-text studies published on MEDLINE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index ≥ 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the I (2) statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed.
resultsThe meta-analysis included 13 studies, of which 10 reported results on renin (n = 470 cases and controls), 7 on angiotensin II (AngII, n = 384), and 9 on aldosterone (n = 439). AngII levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI: 2.00-4.79, P < 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension (mean differences = 1.32 ng/dL, 95% CI: 0.58-2.07, P = 0.0005). Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL (95% CI: 0.88-1.82, P < 0.00001) emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies.
conclusionsOSA is associated with higher AngII and aldosterone levels, especially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.