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[Prevalence of microalbuminuria in recent-onset essential hypertension]
S Cottone1, A Contorno, E Nardi
1Cattedra di Medicina Interna, Università degli Studi, Palermo.
Abstract:
To determine the prevalence of increased microalbuminuria (AER) in essential hypertension, we studied an omogeneous population comprehensive of 160 mild-moderate essential hypertensives (EH) and 30 normotensive controls. All subjects underwent measurement of AER and creatinine clearance (CCl) on the 24-hour urine collection, and of plasma renin activity (PRA). The 24-hour mean arterial pressure (24h-BP) was also obtained by non-invasive ambulatory BP monitoring. The EH were subdivided into subgroups on the basis of their AER values (less or over 11 micrograms/min). Among the 160 EH the prevalence of high AER levels was of 37.5% (n = 60), showing in this subgroup of EH a mean value of 29.5 +/- 4 micrograms/min. Moreover, in the whole population of 160 EH, AER was significantly correlated to 24h-diastolic BP (p < 0.05). The subgroup of 60 EH with AER > 11 micrograms/min showed also Ccl values higher than the other subgroup of EH (p < 0.02), while non significant differences between age, mean duration of EH, PRA, and 24h-BP, both systolic and diastolic, were observed. Our results lead to hypothesize that in essential hypertension there exists a subgroup of subjects characterized, in the early phase of disease, by high capillary glomerular pressure, GFR and microalbuminuria values.
Insights
A significant subgroup of essential hypertension patients exhibit elevated microalbuminuria (AER) and creatinine clearance (CCl), suggesting early-stage kidney involvement. This highlights potential early markers for hypertension-related kidney disease.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Context:
- Essential hypertension (EH) is a prevalent condition often associated with kidney complications.
- Microalbuminuria (AER) is an early indicator of kidney damage.
- Understanding the prevalence and characteristics of AER in EH is crucial for early intervention.
Purpose:
- To determine the prevalence of increased microalbuminuria (AER) in a homogeneous population of mild-to-moderate essential hypertensives (EH).
- To investigate the relationship between AER, 24-hour blood pressure (24h-BP), creatinine clearance (CCl), and plasma renin activity (PRA) in EH patients.
- To identify subgroups within EH based on AER levels and their associated physiological parameters.
Summary:
- A study of 160 mild-to-moderate EH patients and 30 controls found that 37.5% (n=60) had elevated AER (>11 µg/min).
- Elevated AER in EH was significantly correlated with 24-hour diastolic blood pressure (p < 0.05).
- The subgroup with high AER also exhibited higher creatinine clearance (CCl) (p < 0.02), suggesting increased glomerular filtration rate (GFR) and potentially higher capillary glomerular pressure in early EH.
Impact:
- These findings suggest a distinct subgroup of EH patients in the early disease phase characterized by high capillary glomerular pressure, GFR, and microalbuminuria.
- This identification could lead to targeted monitoring and therapeutic strategies for preventing hypertension-related kidney disease progression.
- The study underscores the importance of assessing AER as an early marker in managing essential hypertension.