Microalbuminuria as predictor of increased mortality in elderly people.

Abstract

Manchester et al from Denver reported a series of 257 pregnancies which were complicated by suspected fetal abnormality on ultrasonography.' Thirty seven per cent of the infants born had additional anomalies not detected by prenatal ultrasonography, and the authors concluded that prenatal diagnoses based on ultrasonography were remarkably accurate but were insensitive to associated anomalies in individual cases. Our study confirms this, a revised diagnosis being made in 53 (40%) of such cases.We believe that examination of midtrimester fetuses by a clinical geneticist is a worthwhile service and improves diagnosis, which in turn benefits the diagnostic teams and parental counselling. It is best carried out by a clinician experienced in dysmorphology, used to normal variations in the appearance of fetuses at various stages in gestation, and familiar with rare dysmorphic syndromes. The collaboration of cytogeneticists and paediatric pathologists is important in defining the full extent of the anomalies in order to arrive at the final post-termination diagnosis, on which the parents will base their future reproductive decisions.We thank Dr T Andrews, regional cytogenetic servicc, anXr his staff and Dr A J Barson, department of pacdiltric pathology, University of Manchester, and his staff for their skilled work and cooperation.

Silent ischemia is more prevalent among hypertensive patients with microalbuminuria and salt sensitivity

“…The difference in cardiovascular events among patients with microalbuminuria persisted even when patients with hypertension were excluded. Similar results have been observed by Winocour et al 44 After a follow-up of 62-83 months, Damsgaard et al [45][46] reported a greater incidence of strokes and other cardiovascular events in elderly nondiabetic subjects with increased UAE than in those with normal UAE.…”

“…7 A wide variability of UAE has also been shown among normotensive healthy subjects. [8][9][10] The increasing interest in the significance of microalbuminuria derives, in large part, from the recognition that a rise in UAE is associated with an increased incidence of cardiovascular complications 11 and morbid events, such as left ventricular hypertrophy, [12][13][14] myocardial ischemia, 15,16 hypertensive retinopathy, and increased thickness of the carotid artery. 17 The predictive value of microalbuminuria persists even when data are corrected for age, sex, obesity and levels of blood pressure.…”

Proteinuria and metabolic syndrome as predictors of cardiovascular death in non-diabetic and type 2 diabetic men and women

“…Our finding that proteinuria alone predicted CVD is also in accord with findings from other studies [1][2][3][4][5][6][7][8][9][10][11][12]. Microalbuminuria has been shown to be related to insulin resistance and hyperinsulinaemia [35][36][37][38][39], and other components of metabolic syndrome, including blood pressure [40,41], high levels of triglycerides and apolipoprotein B [42,43] and obesity [44].…”

“…Microalbuminuria and proteinuria predict cardiovascular disease (CVD) events, not only in diabetic [1][2][3][4][5][6][7], but also in non-diabetic individuals [5,[8][9][10][11][12]. Microalbuminuria was included in the WHO definition of the metabolic syndrome in 1998 [13], but since then there has been debate about microalbuminuria as a component of the metabolic syndrome [14].…”

Microalbuminuria in essential hypertension

“…[1][2][3] In maturity onset diabetes and in elderly subjects, microalbuminuria predicts premature cardiovascular mortality 3,4 and in men of the general population aged Ͼ40 years is an independent risk factor for coronary artery disease. 5 In essential hypertension, microalbuminuria is a recognised marker of cardiovascular complications and a reliable predictor of ischaemic heart disease.…”