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An effective indicator in predicting cardiovascular events: urine albumin to creatinine ratio

H Zhao1, Y-F Jiang, X-C Zhou

  • 1Department of Emergency, Shanghai TCM - Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. fdy65@126.com.

European Review for Medical and Pharmacological Sciences
|August 4, 2017
PubMed

Insights

Elevated urine albumin to creatinine ratio (UACR) in elderly hypertensive patients significantly increases the risk of cardiovascular events like heart attack and stroke. Early prevention strategies targeting UACR levels can reduce these risks.

Area of Science:

  • Cardiology
  • Nephrology
  • Geriatrics

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Trace albuminuria, indicated by urine albumin to creatinine ratio (UACR), is increasingly recognized as a marker for cardiovascular risk.
  • Early identification of high-risk individuals is crucial for effective cardiovascular event prevention.

Purpose of the Study:

  • To investigate the relationship between varying levels of urine albumin to creatinine ratio (UACR) and the incidence of new cardiovascular events in elderly hypertensive patients.
  • To establish UACR as a predictive marker for cardiovascular events in this demographic.
  • To provide evidence for early preventive interventions based on UACR levels.

Main Methods:

  • A cohort of 3564 elderly hypertensive patients was stratified into four groups based on their UACR levels.
  • Patients were followed for an average of 3.8 years to monitor the occurrence of new cardiovascular events.
  • Multivariate Cox proportional hazards regression analysis was employed to assess the risk associated with different UACR levels.

Main Results:

  • Patients in the highest UACR group (Group D) exhibited a significantly higher relative risk for cardiocerebrovascular events (1.74 times), cerebral infarction (1.66 times), and acute myocardial infarction (2.48 times) compared to the lowest UACR group (Group A).
  • Higher UACR levels were associated with female sex, older age, higher body mass index, elevated systolic blood pressure, and adverse lipid profiles (higher TG, TC, LDL-C; lower HDL-C).
  • The incidence of sudden cardiac death, acute myocardial infarction, cerebral hemorrhage, and cerebral infarction was notably higher in Group D during the follow-up period.

Conclusions:

  • Urine albumin to creatinine ratio (UACR) is a valuable indicator for stratifying cardiovascular risk in elderly hypertensive patients.
  • Higher UACR levels are significantly associated with an increased risk of major adverse cardiovascular and cerebrovascular events.
  • Monitoring UACR levels can guide early preventive strategies to mitigate the occurrence of cerebral infarction and myocardial infarction in this population.
Abstract

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