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[Microalbuminuria and left ventricular hypertrophy in essential arterial hypertension. A study in non-diabetic
G Berrut1, A M Chameau, B Bouhanick
1Service de Médecine B, CHRU, Angers.
Insights
Essential hypertension is linked to left ventricular hypertrophy, indicated by the Sokolow index. Increased urinary albumin excretion, a marker for kidney damage, strongly correlates with this cardiac change in hypertensive patients without diabetes.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Context:
- Essential hypertension is a prevalent cardiovascular risk factor.
- Left ventricular hypertrophy (LVH) is a common complication of hypertension.
- Microalbuminuria is an early marker of kidney damage and cardiovascular risk.
Purpose:
- To investigate the cross-sectional relationship between urinary albumin excretion (UAE) and left ventricular hypertrophy (LVH) in essential hypertension.
- To identify determinants of UAE in hypertensive patients without diabetes.
Summary:
- A study of 64 essential hypertension patients without diabetes found a significant correlation between UAE and the Sokolow index (r = 0.483, P = 0.0001).
- Multivariate regression identified the Sokolow index and diastolic blood pressure as independent predictors of UAE.
- The findings were consistent regardless of angiotensin I-converting enzyme inhibitor use.
Impact:
- The strong association suggests LVH contributes to cardiovascular risk in hypertensive individuals with microalbuminuria.
- Highlights the importance of monitoring both cardiac and renal function in hypertension management.
- Provides insights into the pathophysiology linking hypertension, LVH, and kidney damage.
Abstract:
To evaluate the relationship between urinary albumin excretion and left ventricular hypertrophy in essential hypertension, we studied, cross-sectionally, 64 subjects with essential hypertension and no diabetes. Urinary albumin excretion and Sokolow index correlated significantly (r = 0.483; P = 0.0001). Five subjects were positive for microalbuminuria (> 30 mg/24 h) and Sokolow index (> 35 mm); 43 were negative for both, with a concordance rate of 77 percent (chi-squared test 11.1; P = 0.0009). Stepwise multivariate regression analysis indicated two independent determinants for urinary albumin excretion: Sokolow index (F = 18.29), and diastolic blood pressure (F = 12.23). The relationships between urinary albumin excretion, Sokolow index, and blood pressure were not different in the 18 subjects taking angiotensin I-converting enzyme inhibitors and in the 46 others. The close relationship between urinary albumin excretion and Sokolow index observed in this study suggests that left ventricular hypertrophy due to hypertension may account for the increased cardiovascular mortality observed in non diabetic subjects with microalbuminuria.