Prevalence of microalbuminuria in hypertension monitored in primary care

Abstract

The objectives of the study were to evaluate the prevalence of microalbuminuria (MAU) in patients with hypertension, monitored in primary care and to analyse the correlation between MAU, risk factors and associated parameters. Material and methods. During 2010-2014 we evaluated a number of 910 patients from 19 family medicine offices of Timiş County. The general practitioners took a standardized history, performed a physical examination, measured height, weight, blood pressure, ABPM and heart rate, calculated body mass index and tested urine for MAU with Arkray test strips. The patients with hypertension and MAU were referred to diagnosis centres where they underwent echocardiography. Results. After exclusion of patients with a history of renal disease and diabetes, MAU was present in 61 cases, 7.1%. The mean age of the MAU positive patients was 56±13.1 years, ranging from 29 to 79. The duration of hypertension was under 5 years in 4 (2.44%) patients, between 5-10 years in 35 (57.3%) and over 10 years in 22 (36%) Six patients with MAU (9.83%) had mild hypertension, 25 (40.9%) moderate and 30 (49.1%) severe hypertension. LVMI was 125 ± 28 g/m2 in the MAU absent group and 157 ± 56 g/m2 in the MAU present group (<0.04). A stepwise logistic regression analysis showed significant positive effects of 24 h systolic blood pressure, weight and LVH (p<0.001 for all comparisons) on MAU. No other variable had a significant predictive effect on the presence or absence of MAU. Conclusions. In patients with essential hypertension MAU was present in 7.1%, with a higher prevalence in uncontrolled than in controlled hypertension. MAU was associated with high blood pressure levels, obesity and LVH.

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

“…Data from the Spanish Society of Hypertension on 68,045 patients with ABPM, indicate a 12.2% prevalence of RH [28]. The prevalence of RH has a growing tendency, concomitant with the growing prevalence of obesity, diabetes, sleep apnoea and aging of the population [29,30]. In the Controlled Onset Verapamil Investigation of Cardiovascular Endpoints (CONVINCE) trial the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), the prevalence of RH was 18% and, respectively, 15 % [31,32].…”

“…Factors involved in RH must be detected and removed [37,38]. Obesity determines excessive sodium retention, sympathetic stimulation, renin-angiotensin system activation, insulin resistance and sleep apnoea [39][40][41][42].…”