[Determination of urinary albumin excretion in arterial hypertension]

Urinary albumin excretion (UAE) measurement is recommended in the diagnosis and follow-up of the hypertensive patient. The aim of the study was to evaluate the proportion of hypertensives attended in Primary Care who had an evaluation of UAE in the last year, along with the methodology of the measurement.

A total of 958 investigators consecutively recruited 4786 hypertensives (first five patients who attended). When present, the measurement of UAE during the last year was obtained from clinical records. In those having this measurement, the type of urine collection (24hours, nighttime or morning spot), as well as the value and units of measure (mg/24h, μg/min, mg/g or mg/L) were recorded.

Mean age was 66 years. 51% were men and 49% women. UAE was determined in 2301 patients (48.1%). In 329, 24-hour urine was collected, nighttime urine in 122 and in 1850 the collection came from a morning spot sample. However, only 696 patients from the latter group had the value of albumin corrected by the creatinine excretion. Thus, only 24% of hypertensive patients had a valid UAE measurement (mg/24h, μg/min or mg/g). Prevalence of microalbuminuria was 36%. The UAE determination was associated with older age, obesity, diabetes and better blood pressure control rates.

Only half of hypertensive patients have a UAE measurement and in only 1 out of 4 a validated methodology has been used. It seems necessary a reinforcement of the messages contained in guidelines, as well as its applicability to any particular setting in order to promote a generalized and correct evaluation of UAE in hypertension.