Correlation Between Bp Variability, Insulin Resistance and Microalbuminuria

Abstract

Objective:Fueled by a global pandemic of cardiovascular diseases, hypertension (HT) remains the leading cause of early mortality in the world. Blood pressure variability (BPV) is considered to be in relation to a worse prognosis. Disrupted blood pressure variability (BPV) and insulin resistance (IR) often coexist as” satellite conditions”. This association potentiate the target organ damages (TOD). Microalbuminuria (MA) is an important biomarker of extra-cardiac damage, and subsequently, hypertension and/or carbohydrate metabolism’s alteration can lead to abnormalities in urinary albumin excretion. Each of these conditions can increase adverse hazards per se or via promoting hypertension or extracardiac injuries.Aim: To determine the correlation between disrupted BPV, level of carbohydrate metabolism’s alteration and microalbuminuria.Design and method:101 patients with essential hypertension (49,5% men; mean age 50,11 ± 0,79 years, mean BMI 24.4 ± 0.5 kg/m2; eGRF > 60 ml/min/1.73m2) with excessive BPV (systolic BP> 15 mmHg; diastolic BP > 14 mmHg), IR and microalbuminuria. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE), HOMA-IR and Ma were performed. The BPV was referred to the software analysis of ABPM data. To define IR was used The Homeostasis Model Assessment of insulin resistance (HOMAIR) levels; threshold values was considered > 2. MA was appreciated according to the current guidelines (30–300 mg/24 h). Correlation analysis was performed using Pearson’s test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong> 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001.Results:Excessive BPV, HOMA-IR and MA indices demonstrate a statistically significant correlation (p < 0.001). Systolic BPV demonstrated a particularly strong relationship with higher HOMA-IR levels and MA (p < 0.05) (Table 1).Conclusions: In hypertensive patients, disrupted BP variability strongly correlates with microalbuminuria and carbohydrate metabolism abnormality. This association appears to have a particularly strong relationship with systolic BPV and correlates with higher HOMA-IR levels.