Relationship between microalbuminuria and cardiac structural changes in mild hypertensive patients

Abstract

The aim of this study was to determine the relationship between urinary albumin excretion (UAE), cardiac structural changes upon echocardiography and 24-h ambulatory blood pressure (ABPM) levels. Twenty mild hypertensive patients (mean age 56.8 ± 9.6 years) were evaluated. After 2 weeks of a washout period of all antihypertensive drugs, all patients underwent an echocardiographic evaluation, a 24-h ABPM and an overnight urine collection. Systolic and diastolic blood pressure during 24-h ABPM was 145 ± 14/91 ± 10 mmHg (daytime) and 130 ± 14/76 ± 8 mmHg (nighttime), respectively. Seven (35%) patients presented UAE ≥15 µg/min, and for the whole group, the geometric mean value for UAE was 10.2 x/÷ 3.86 µg/min. Cardiac measurements showed mean values of interventricular septum thickness (IVS) of 11 ± 2.3 mm, left ventricular posterior wall thickness (PWT) of 10 ± 2.0 mm, left ventricular mass (LVM) of 165 ± 52 g, and left ventricular mass index (LVMI) of 99 ± 31 g/m 2 . A forward stepwise regression model indicated that blood pressure levels did not influence UAE. Significant correlations were observed between UAE and cardiac structural parameters such as IVS (r = 0.71, P<0.001), PWT (r = 0.64, P<0.005), LVM (r = 0.65, P<0.005) and LVMI (r = 0.57, P<0.01). Compared with normoalbuminuric patients, those who had microalbuminuria presented higher values of all cardiac parameters measured. The predictive positive and negative values of UAE ≥15 µg/min for the presence of geometric cardiac abnormalities were 75 and 91.6%. These data indicate that microalbuminuria in essential hypertension represents an early marker of cardiac structural damage.

Obesidade visceral, hipertensão arterial e risco cárdio-renal: uma revisão

“…Além de espelhar o dano renal, a MA tem sido utilizada como sinalizador incipiente de dano endotelial vascular e preditora de risco cardiovascular (74,75).…”

The Potential Role of Circulating Endothelial Cells and Endothelial Progenitor Cells in the Prediction of Left Ventricular Hypertrophy in Hypertensive Patients

“…An increased concentration of biochemical markers of endothelial dysfunction, such as inter-cellular adhesion molecule 1 (ICAM-1), vascular cell adhesion protein 1 (VCAM-1) and E-selectin, were observed in hypertensive patients with LVH (Kuroda et al, 2001; Malmqvist et al, 2002). Moreover, endothelial damage reflected by abnormal albuminuria was independently associated with LVH occurrence in hypertensive patients, including those with RH (Plavnik et al, 2002; Salles et al, 2007; Nabbaale et al, 2015). However, all of the previously analyzed parameters of endothelial dysfunction are not highly specific and their level is subject to intra-patient variability and also strongly depends on renal function.…”

Study of microalbuminuria in essential hypertension patients with target organ damage

“…MA was observed to be present in 69(57.5%) participants, which is higher than that reported in previous similar studies (6.7%-40.0%). 5,[12][13][14][15] This could partly be explained by the comparatively higher levels of BP amongst participants in the present study, and that most of the patients were not compliant to treatment.…”

“…12,13 The presence of MA is thought of as the renal manifestation of generalized increased endothelial dysfunction occurring as part of the disease process; which leads to the hypothesis that certain degree of correlation continuum exists between CV risk factors and the process from early to final renal damage. 15,20,21…”