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Microalbuminuria in essential hypertension: clinical and biochemical profile
A de la Sierra1, E Bragulat, C Sierra
1Hypertension Unit, Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic, University of Barcelona, Spain. asierra@clinic.ub.es
Insights
Microalbuminuria in essential hypertension is linked to higher blood pressure and kidney impairment. It also correlates with elevated uric acid, triglycerides, and lower HDL-cholesterol levels.
Area of Science:
- Nephrology
- Cardiology
- Clinical Biochemistry
Background:
- Microalbuminuria is an early marker of kidney damage.
- Essential hypertension is a major risk factor for cardiovascular and renal diseases.
Purpose of the Study:
- To investigate the clinical and biochemical factors associated with microalbuminuria in essential hypertensive patients.
- To identify predictors of microalbuminuria in this population.
Main Methods:
- Study included 188 non-diabetic, untreated essential hypertensive patients.
- Assessed urinary albumin excretion, 24-hour ambulatory blood pressure, and biochemical markers.
- Used multiple logistic regression to identify independent factors.
Main Results:
- 22.3% of patients had microalbuminuria.
- Microalbuminuria was associated with higher 24-hour systolic and diastolic blood pressure.
- Patients with microalbuminuria had higher creatinine, uric acid, triglycerides, and lower HDL-cholesterol.
Conclusions:
- Microalbuminuria in essential hypertension is associated with elevated blood pressure and renal impairment.
- It is also linked to dyslipidemia and hyperuricemia.
- Circadian blood pressure patterns were not significantly different between groups.
Abstract:
This study aims to evaluate the clinical and biochemical profile associated with the presence of microalbuminuria in a group of essential hypertensive patients referred to a hypertension clinic. A total of 188 non-diabetic, untreated essential hypertensive patients (100 men, 88 women) aged 55.8 +/- 11.7 years are studied. Urinary albumin excretion was determined in two 24-h urine collections. Clinical and biochemical evaluations and 24-h ambulatory blood pressure (BP) monitoring were performed at baseline. Forty-two patients (22.3%) showed an increased urinary albumin excretion rate (20-200 micrograms/min). These patients showed significantly higher values (P < 0.01) for 24-h, daytime and night-time systolic and diastolic BP, compared with essential hypertensives with normal urinary albumin excretion. However, nocturnal reduction in BP did not differ between the groups. Furthermore, patients with microalbuminuria showed significantly higher (P < 0.01) creatinine, serum uric acid and triglycerides, as well as lower high-density lipoprotein (HDL)-cholesterol. In a multiple logistic regression analysis, a 24-h systolic BP > 140 mmHg (odds ratio: 3.19; 95% confidence interval [CI 95%]: 1.44-7.06) and a serum creatinine > 88 mumol/L (odds ratio: 3.08; CI 95%: 1.39-6.84) were the two factors associated independently with increased urinary albumin excretion. We conclude that, in essential hypertensive patients, the presence of microalbuminuria is associated with elevated BP, but not with its circadian pattern. Likewise, microalbuminuria is associated with the degree of renal impairment, and with increased uric acid and triglycerides and decreased HDL-cholesterol.