Related Experiment Videos
Microalbuminuria in treated hypertensive men at high risk of coronary disease. The Risk Factor Intervention Study
S Agewall1, B Persson, O Samuelsson
1Department of Medicine, Sahlgren's Hospital, University of Gothenburg, Sweden.
Insights
Microalbuminuria in hypertensive men without diabetes was linked to insulin resistance factors. It showed low sensitivity for detecting existing cardiovascular disease.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Hypertension is a major risk factor for cardiovascular disease (CVD).
- Microalbuminuria, a marker of kidney damage, is increasingly recognized as a CVD risk indicator.
- The role of microalbuminuria in hypertensive individuals without diabetes requires further investigation.
Purpose of the Study:
- To determine if microalbuminuria serves as a marker for CVD in treated hypertensive men without diabetes and high coronary risk.
- To explore associations between microalbuminuria and established cardiovascular risk factors.
Main Methods:
- A cross-sectional study involving 333 treated hypertensive men (aged 50-72) with high coronary risk (high cholesterol or smokers).
- Exclusion criteria included diabetes mellitus and high overnight urinary albumin excretion (>100 mg/12 h).
- Measurements included urinary albumin excretion, prevalence of microalbuminuria (17-100 mg/12 h), organ damage, cardiovascular risk factors, and glucose/insulin responses.
Main Results:
- Microalbuminuria was present in 25% of the cohort.
- Organ damage was more frequent in microalbuminuric patients (47.6%) versus normoalbuminuric patients (30.9%).
- Microalbuminuria correlated significantly with body mass index, waist:hip ratio, age, and plasma insulin levels, independent of antihypertensive treatment.
Conclusions:
- In treated hypertensive men without diabetes, microalbuminuria is associated with factors related to insulin resistance.
- Microalbuminuria demonstrated low sensitivity (34%) as a marker for concurrent cardiovascular disease in this population.
Objective:
To examine whether microalbuminuria is a marker of cardiovascular disease in treated hypertensive men without diabetes mellitus at high coronary risk and to examine the associations between microalbuminuria and recognized cardiovascular risk factors.
Design:
Cross-sectional study.
Setting:
Outpatient clinic in city hospital.
Patients:
Three hundred and thirty-three treated hypertensive men, aged 50-72 years, either with a serum cholesterol of > or = 6.5 mmol/l or smokers, or both. The patients were recruited mainly from a population-based sample of hypertensive men. Patients with diabetes mellitus or overnight urinary albumin excretion of > 100 mg/12 h were excluded from the analyses.
Main Outcome Measures:
Overnight urinary albumin excretion, prevalence of microalbuminuria (defined as 17-100 mg/12 h) and organ damage (cardiovascular events or major electrocardiogram changes, or both), various well-established risk factor levels, blood glucose and plasma insulin responses to an oral glucose tolerance test.
Results:
Microalbuminuria was found in 25% of the cohort. Among microalbuminuric patients, organ damage was significantly more common (47.6%) than in the normoalbuminuric group (30.9%). However, the sensitivity and specificity of microalbuminuria as a marker of organ damage were only 34 and 80%, respectively. Microalbuminuria was significantly related to body mass index and waist:hip ratio, age and plasma insulin during oral glucose tolerance testing. These relationships also persisted after adjustment for treatment with thiazides or beta-blockers.
Conclusions:
In treated hypertensive men without diabetes mellitus, microalbuminuria was associated with factors known to be related to insulin resistance. It had a low sensitivity as a marker of concomitant cardiovascular disease.