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Microalbuminuria in essential hypertensives in treatment for hypertension
H M Cruz1, A B Cruzera, J Cruz
1Department of Internal Medicine, University of São Paulo School of Medicine, Brazil.
Insights
Essential hypertension is linked to increased urinary albumin excretion (UAE), a marker of kidney damage. Higher blood pressure and body mass index (BMI) significantly correlate with elevated UAE in hypertensive patients without diabetes.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Background:
- Essential hypertension is a major risk factor for cardiovascular and renal diseases.
- Urinary albumin excretion (UAE) is a sensitive indicator of early kidney damage.
- Understanding factors influencing UAE in hypertensive individuals is crucial for risk stratification.
Purpose of the Study:
- To evaluate urinary albumin excretion (UAE) in patients with essential hypertension.
- To investigate the correlation between UAE and clinical/laboratorial parameters, including blood pressure and body mass index (BMI).
- To identify predictors of microalbuminuria in this population.
Main Methods:
- Study included 26 subjects with essential hypertension and normal renal function (creatinine clearance > or = 75 ml/min/1.73 m2).
- UAE, blood pressure, BMI, and other clinical data were collected.
- Statistical analysis was performed to assess correlations between UAE and various parameters.
Main Results:
- UAE showed significant positive correlations with systolic, diastolic, and mean arterial blood pressure.
- Body Mass Index (BMI) was also positively correlated with UAE and blood pressure.
- Microalbuminuria (UAE > 13.9 micrograms/min) was present in 19% of the subjects, with higher blood pressures observed in this subgroup.
Conclusions:
- Elevated UAE in essential hypertension is strongly associated with higher blood pressure levels.
- Increased BMI is a significant factor contributing to both higher UAE and blood pressure.
- These findings highlight the importance of blood pressure and weight management in preventing kidney damage in hypertensive patients.
Abstract:
Urinary albumin excretion (UAE) was evaluated in 26 subjects with essential hypertension and no diabetes (5 men, 21 women; 19 whites and 7 blacks), with creatinine clearance (Ccreat) > or = 75 ml/min/1.73 m2, in individualized treatment with various antihypertensive drugs. Clinical and laboratorial data were the following: mean age, 53 +/- 2 years (SEM); duration of hypertension, 14.9 +/- 2.2 years; body mass index (BMI), 26.8 +/- 0.7; arterial blood pressure, 142 +/- 4/89 +/- 3 mmHg; serum creatinine, 0.8 +/- 0.03 mg/dL; Ccreat, 99.3 +/- 3.8 ml/min/1.73 m2 and UAE, 9.3 +/- 1.5 micrograms/min. No significant difference was found when data were evaluated for gender and race. Microalbuminuria, defined as UAE > 13.9 micrograms/min, was found in 19% of the hypertensives (range: 16.3 to 28.1 micrograms/min). UAE correlated positively and significantly with systolic (r = 0.6309; P = 0.0005), diastolic (r = 0.4146; P = 0.0352), and mean blood pressure (r = 0.5000; P = 0.0093). The correlation between UAE and systolic pressure was stronger than with diastolic pressure. There was a positive and significant correlation between BMI and UAE values (r = 0.5623; P = 0.0028), and between BMI values with those of systolic (r = 0.5271; P = 0.0057) and mean blood pressure (r = 0.3930; P = 0.470). No correlation was found between UAE and age, duration of hypertension or Ccreat. Systolic, diastolic and mean blood pressures were significantly higher in microalbuminuric than in non microalbuminuric hypertensives. Obese hypertensives presented higher mean values of UAE, systolic, diastolic and mean pressures than non obese.