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Microalbuminuria as a marker of preclinical diastolic dysfunction in never-treated essential hypertensives

A M Grandi1, R Santillo, A Bertolini

  • 1Department of Clinical and Biological Sciences, Faculty of Medicine, University of Insubria, Varese, Italy. amgrandi@libero.it

American Journal of Hypertension
|July 24, 2001
PubMed

Insights

Microalbuminuria, an early sign of kidney damage, is linked to preclinical heart dysfunction in hypertensive patients. This finding highlights its role as a reliable marker for early cardiac involvement.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Microalbuminuria is an early indicator of kidney damage and is associated with increased cardiovascular risk.
  • Preclinical left ventricular (LV) dysfunction may precede symptomatic heart failure in hypertensive individuals.

Purpose of the Study:

  • To investigate the relationship between microalbuminuria and preclinical left ventricular (LV) diastolic dysfunction in never-treated hypertensive patients.
  • To determine if microalbuminuria is an independent marker of cardiac involvement in hypertension.

Main Methods:

  • 24-hour ambulatory blood pressure (BP) monitoring and digitized M-mode echocardiography were used.
  • 87 never-treated hypertensive patients were evaluated.
  • Urinary albumin excretion (UAE) was measured from two 24-hour urine collections to classify patients as microalbuminuric (MA+) or normoalbuminuric (MA-).

Main Results:

  • Microalbuminuria (MA+) was present in 28 patients; 59 had normal UAE (MA-).
  • MA+ patients exhibited significantly higher 24-h, daytime, and nighttime BP compared to MA-.
  • MA+ group showed increased LV mass index, higher prevalence of LV hypertrophy, and impaired LV diastolic function (lower peak lengthening rate of LV diameter and peak thinning rate of posterior wall).
  • UAE was inversely correlated with LV diastolic function indices, independent of age, heart rate, BP, and LV mass.

Conclusions:

  • Microalbuminuria is associated with greater myocardial mass and preclinical impairment of LV diastolic function in never-treated hypertensive patients.
  • This relationship is independent of elevated BP or LV mass, reinforcing microalbuminuria's role as an early marker of preclinical cardiac involvement.
  • Microalbuminuria serves as a reliable indicator of early cardiac changes in hypertensive individuals.

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