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Racial differences in the prevalence of microalbuminuria in hypertension
J H Summerson1, R A Bell, J C Konen
1Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27157, USA.
Insights
Black hypertensive patients show higher urinary albumin excretion rates and microalbuminuria compared to white patients. This suggests microalbuminuria may be an early indicator of end-organ damage susceptibility in Black individuals with hypertension.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Background:
- Essential hypertension disproportionately affects Black populations, with higher rates of hypertensive renal failure.
- Racial disparities in end-organ damage related to hypertension are well-documented.
- The role of early markers like microalbuminuria in these disparities requires further investigation.
Purpose of the Study:
- To investigate potential racial differences in urinary albumin excretion rates among patients with essential hypertension.
- To determine if microalbuminuria is more prevalent in Black hypertensive patients compared to White hypertensive patients.
- To identify potential early markers for end-organ damage susceptibility in hypertensive individuals.
Main Methods:
- A study was conducted on 109 patients with essential hypertension, excluding those with diabetes mellitus or clinical proteinuria.
- Urinary albumin excretion rates were measured and compared between Black and White patient groups.
- Statistical analyses were performed to assess differences and account for confounding factors such as age, blood pressure, and BMI.
Main Results:
- Black hypertensive patients exhibited significantly higher urinary albumin excretion rates than White hypertensive patients.
- A significantly greater proportion of Black patients (32%) had microalbuminuria compared to White patients (14%).
- These observed differences were not attributable to age, blood pressure, BMI, glycosylated hemoglobin, serum creatinine, hypertension duration, or treatment type.
Conclusions:
- Microalbuminuria may be more prevalent in Black patients with hypertension.
- Microalbuminuria could serve as an early marker for end-organ damage susceptibility in hypertensive Black patients.
- These findings highlight potential racial disparities in the early stages of hypertensive kidney damage.
Abstract:
One hundred nine patients with essential hypertension and without either diabetes mellitus or clinical proteinuria were examined to investigate possible racial differences in urinary albumin excretion rates. The black hypertensive patients were found to have significantly higher urinary albumin excretion rates compared with the white patients; in addition, a significantly greater proportion of the black patients than the white patients (32% v 14%) had microalbuminuria, defined as a urinary albumin excretion rate greater than 30 micrograms/min. These differences could not be explained by age, blood pressure, body mass index, glycosylated hemoglobin, serum creatinine, duration of hypertension, or type of hypertension treatment. Hypertensive renal failure occurs six to 18 times more frequently in blacks than in whites; to our knowledge, these data are the first to indicate that microalbuminuria may be more prevalent during the course of hypertension in black patients and thus may be an early marker for end-organ damage susceptibility among hypertensive patients.