Elevated albumin excretion in nonmodulating essential hypertensive patients

Area of Science:

• Nephrology
• Cardiology
• Endocrinology

Background:

• Nonmodulating (NM) essential hypertension is associated with abnormal renal and aldosterone responses to angiotensin II.
• NM hypertensives exhibit hyperinsulinemia, hypercholesterolemia, and a higher prevalence of hypertension and myocardial infarction in family history.
• Elevated urinary albumin excretion (UAE) is a negative prognostic marker for cardiovascular diseases in essential hypertension.

Purpose of the Study:

• To evaluate urinary albumin excretion (UAE) in male patients with essential hypertension categorized as low renin (LR), modulating (M), and NM.
• To compare UAE levels between hypertensive subgroups and healthy controls under different sodium intake conditions.
• To investigate the relationship between UAE, low-density lipoprotein cholesterol, and hypertension phenotype.

Main Methods:

• Fifty male patients with mild to moderate essential hypertension (LR, M, NM) and 14 healthy male controls were studied.
• Subjects underwent graded angiotensin II infusion to assess aldosterone response.
• Urinary albumin excretion (UAE) was measured in subjects on both high (200 mmol NaCl/day) and low (10 mmol NaCl/day) sodium diets.

Main Results:

• NM patients exhibited significantly higher UAE compared to controls, LR, and M patients on a high-sodium diet (p < 0.0001).
• UAE differences between groups disappeared on a low-sodium diet.
• NM patients showed higher low-density lipoprotein cholesterol levels and a positive correlation between UAE and cholesterol (r = 0.579, p < 0.05).

Conclusions:

• The NM phenotype of essential hypertension is associated with elevated UAE.
• Elevated UAE in NM patients may indicate an increased cardiovascular risk.
• Dietary sodium intake influences UAE levels in different essential hypertension phenotypes.