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Urinary albumin and cardiovascular profile in the middle-aged population
Massimo Cirillo1, Cinzia Lombardi, Giancarlo Bilancio
1Department of Nephrology, Second University of Naples, Naples, Italy. massimo.cirillo@unina2.it
Abstract:
The moderate increase in urinary albumin excretion defined as microalbuminuria is not rare and is associated with cardiovascular risk factors. Microalbuminuria prevalence is low in the absence of cardiovascular risk factors and progressively increases with the number cardiovascular risk factors. The main correlate of microalbuminuria is blood pressure, either systolic or diastolic pressure. The relation between blood pressure and microalbuminuria is continuous and graded because the microalbuminuria prevalence increases with the severity of hypertension. Among hypertensive patients on drug treatment, blood pressure control is associated with a low prevalence of microalbuminuria. Thus, blood pressure appears as a determinant of microalbuminuria rather than a mere correlate. For hypercholesterolemia, smoking, and diabetes, data are less strong but point to an independent positive association with microalbuminuria. Altogether, data indicate that microalbuminuria in the population reflects the presence of cardiovascular risk factors. Data on microalbuminuria and coronary heart disease support this idea. There is a continuous and graded relation between urinary albumin excretion and coronary heart disease prevalence. High urinary albumin excretion is likely a sign of vascular damage existing both at the renal and cardiac levels and induced by 1 or more uncontrolled cardiovascular risk factors.
Insights
Microalbuminuria, an early sign of kidney damage, is common in people with cardiovascular risk factors. Managing blood pressure is key, as it strongly influences microalbuminuria and heart disease risk.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Microalbuminuria, a marker of kidney damage, is increasingly recognized as a significant indicator of cardiovascular risk.
- Its prevalence rises with the number of cardiovascular risk factors present.
Purpose of the Study:
- To investigate the association between microalbuminuria and various cardiovascular risk factors.
- To determine the role of blood pressure as a primary determinant of microalbuminuria.
Main Methods:
- Observational study analyzing the prevalence of microalbuminuria in relation to cardiovascular risk factors.
- Statistical analysis to assess the correlation and potential causality between blood pressure, other risk factors, and microalbuminuria.
Main Results:
- Microalbuminuria prevalence is low without cardiovascular risk factors but increases progressively with their presence.
- Blood pressure (systolic and diastolic) is the strongest correlate and a determinant of microalbuminuria.
- Hypertension severity is directly related to microalbuminuria prevalence.
- Hypercholesterolemia, smoking, and diabetes show independent positive associations with microalbuminuria.
Conclusions:
- Microalbuminuria in the general population signifies the presence of underlying cardiovascular risk factors.
- Elevated urinary albumin excretion indicates potential vascular damage at both renal and cardiac levels.
- Effective blood pressure control in hypertensive individuals is associated with reduced microalbuminuria prevalence.
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