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Microalbuminuria is related to marked end organ damage in previously untreated, elderly hypertensive patients

W F Terpstra1, J F May, A J Smit

  • 1Department of Cardiology/Thoraxcenter, University Hospital Groningen, The Netherlands. w.f.terpstra@castel.nl

Blood Pressure
|May 31, 2002
PubMed

Insights

Microalbuminuria (MA) indicates end-organ damage in elderly hypertensive patients, even at lower excretion levels. This suggests reconsidering the standard MA threshold for hypertension management.

Area of Science:

  • Cardiology
  • Nephrology
  • Geriatrics

Background:

  • Hypertension is a major risk factor for cardiovascular and renal disease.
  • Microalbuminuria (MA) is a known marker of early kidney damage and cardiovascular risk.
  • The established threshold for MA may not fully capture early end-organ damage in all hypertensive populations.

Purpose of the Study:

  • To investigate if lower urinary albumin excretion levels, below the classic definition of MA, correlate with end-organ damage in elderly, non-diabetic, non-atherosclerotic hypertensive patients.
  • To compare end-organ damage markers between hypertensive patients with and without MA.
  • To identify predictors of intima media thickness and left ventricular mass in this population.

Main Methods:

  • A population survey screened 173 untreated hypertensive patients (age 67±4 years) for MA (20-300 mg/24h).
  • End-organ damage was assessed using B-mode ultrasound of carotid/femoral arteries (intima media thickness, IMT) and echocardiography (left ventricular mass index, LVMI).
  • Linear regression analysis was used to determine independent predictors of IMT and LVMI.

Main Results:

  • 8% of patients (14/173) had MA.
  • Hypertensive patients with MA exhibited significantly higher IMT (1.01±0.21 vs 0.88±0.6 mm) and LVMI (118±31 vs 103±22 g/m²) compared to those without MA.
  • MA was independently associated with IMT, while age, male gender, and diastolic blood pressure also predicted IMT. Systolic blood pressure, male gender, and BMI predicted LVMI.

Conclusions:

  • Even below the classical definition, microalbuminuria is associated with significant subclinical cardiovascular damage (increased IMT and LVMI) in elderly hypertensive individuals.
  • Microalbuminuria is an independent predictor of intima media thickness in this population.
  • These findings suggest that the current threshold for defining microalbuminuria may need re-evaluation in the context of hypertension management, particularly in the elderly.

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