Related Experiment Videos
Dissociation between microalbuminuria and common carotid thickness in essential hypertensive men
R Pedrinelli1, G Dell'Omo, G Penno
1Dipartimento Cardio-Toracico, Università di Pisa, Pisa, Italy. r.pedrinelli@int.med.unipi.it
Background:
The reasons why microalbuminuria (albuminuria > or = 15 microg/min), an expression of a renal microcirculatory abnormality, predicts cardiovascular disease in essential hypertension are unsettled. To test the hypothesis that microalbuminuria represents a marker of subclinical atherosclerosis, we evaluated its association with common carotid artery (CCA) intima media thickness (IMT), a measure of preclinical atherosclerosis and an independent predictor of cardiac and cerebrovascular events, in uncomplicated essential hypertensive individuals.
Materials And Methods:
Albuminuria, ultrasonographic CCA IMT (the mean of six bilateral far wall measurements within 1.5 cm proximally to the flow divider), brachial blood pressure (BP), smoking habits and lipids were evaluated in 136 stage 1-3 untreated essential hypertensive men free of cardiovascular disease.
Results:
CCA IMT did not differ between normo- (n = 99) and microalbuminuric (n = 37) patients. The correlation between CCA IMT and albuminuria was not significant, and the prevalence of microalbuminuria across IMT quartiles was not different. Microalbuminuric patients showed higher systolic BP and that parameter was the only independent correlate in a multivariate logistic regression model including also age, CCA IMT, diastolic BP, lipids and smoking habits as independent variables and microalbuminuria as the dependent one.
Conclusion:
This cross-sectional study in hypertensive subjects free of cardiovascular disease has shown a dissociation between microalbuminuria and CCA IMT, a surrogate measure of subclinical atherosclerosis, and a parameter linearly related to cardiovascular events. The data do not support the theory of microalbuminuria as a surrogate measure of subclinical atherosclerosis, while confirming the importance of systolic BP levels as an independent correlate of increased albuminuria in essential hypertension. Journal of Human Hypertension (2000) 14, 831-835
Insights
Microalbuminuria does not appear to be a marker for subclinical atherosclerosis in essential hypertension. Higher systolic blood pressure is the main correlate of increased albuminuria in these patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Hypertension Research
Background:
- Microalbuminuria, a sign of renal abnormality, is linked to cardiovascular disease in hypertension, but its role as a marker for atherosclerosis is unclear.
- Subclinical atherosclerosis, measured by common carotid artery intima-media thickness (CCA IMT), is a predictor of cardiovascular events.
- This study investigates if microalbuminuria correlates with CCA IMT in essential hypertensive individuals.
Purpose of the Study:
- To test the hypothesis that microalbuminuria serves as a marker of subclinical atherosclerosis.
- To evaluate the association between microalbuminuria and CCA IMT in untreated essential hypertensive patients without cardiovascular disease.
Main Methods:
- Evaluated albuminuria, ultrasonographic CCA IMT, blood pressure, smoking, and lipids in 136 untreated essential hypertensive men.
- CCA IMT was measured as the mean of six bilateral far wall measurements.
- Multivariate logistic regression was used to identify correlates of microalbuminuria.
Main Results:
- No significant difference in CCA IMT was found between normoalbuminuric and microalbuminuric patients.
- There was no significant correlation between CCA IMT and albuminuria levels.
- Microalbuminuric patients had higher systolic blood pressure, which was the sole independent correlate of microalbuminuria in multivariate analysis.
Conclusions:
- Microalbuminuria and CCA IMT, a marker of subclinical atherosclerosis, were dissociated in this study population.
- The findings do not support microalbuminuria as a surrogate marker for subclinical atherosclerosis in essential hypertension.
- Elevated systolic blood pressure remains a significant independent correlate of increased albuminuria in essential hypertension.