Several Conventional Risk Markers Suggesting Presence of Albuminuria Are Weak Among Rural Africans With Hypertension

Rasmussen, Jeppe Nørgaard; Nordin, Lovisa S.; Thomsen, Jens Schiersing; Rossing, Peter; Bygbjerg, Ib Christian; Christensen, Dirk L.

doi:10.1111/jch.12662

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…This does not agree with findings from other studies. One such study in an African setting [ 32 ] showed that treatment with calcium channel blockers was associated with microalbuminuria, although our study did not show an association. The questions on medications require a separate study as our study was not powered to answer these questions.…”

Section: Discussioncontrasting

confidence: 96%

Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda

Kangwagye

Rwebembera

Wilson

et al. 2018

International Journal of Nephrology

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Background Routine testing of microalbuminuria and retinopathy is not done among patients with high blood pressure in resource-limited settings. We determined the prevalence of microalbuminuria and retinopathy and their risk factors among hypertensive patients at a large hospital in western Uganda. Methods We consecutively recruited nondiabetic patients with hypertension at the outpatients' clinic over a period of 3 months. Spot urine samples were tested for urine albumin. Direct fundoscopy was done to assess retinal vasculature and optic disc for signs of hypertensive retinopathy. Logistic regression was done with retinopathy and microalbuminuria as primary outcomes. ResultsWe enrolled 334 patients and, of these, 208 (62.3%) were females, with median age of 55 years (range: 25–90). The prevalence of microalbuminuria was 59.3% (95% CI: 50.1–72.2) and that of retinopathy was 66.8% (95% CI: 58.6–76.5). The independent correlates of retinopathy and microalbuminuria were systolic blood pressure (SBP) > 140 mmHg (OR = 2.76, 95% CI: 1.29–5.93) and treatment with beta-blockers (OR = 2.16, 95% CI: 1.05–4.44). Use of ACEIs was unrelated to the study outcomes. ConclusionThe prevalence of retinopathy and microalbuminuria is high. Clinicians should aim for better control of blood pressure and routinely perform fundoscopy and urine albumin, especially for patients with poorly controlled blood pressure.

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Section: Discussioncontrasting

confidence: 96%

Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda

Kangwagye

Rwebembera

Wilson

et al. 2018

International Journal of Nephrology

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“…In this issue of The Journal of Clinical Hypertension , Rasmussen and colleagues from the University of Copenhagen present their investigation on risk markers for albuminuria in patients with hypertension in rural sub‐Saharan Africa (SSA). Exclusion criteria included a positive urine dipstick for nitrites, leukocytes, blood, or fever.…”

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confidence: 99%

Albuminuria in Hypertensive Patients: Where the Choice of Antihypertensive Medications Matters:

Mani

2015

J of Clinical Hypertension

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Hypertension in a resource‐limited setting: Poor Outcomes on Short‐term Follow‐up in an Urban Hospital in Maputo, Mozambique

Manafe

Matimbe

Daniel

et al. 2019

J of Clinical Hypertension

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Mozambique has low levels of detection, treatment, and control of hypertension. However, data on target organ damage and clinical outcomes are lacking. The authors aimed at characterizing the clinical profile, pattern of target organ damage, and short‐term outcomes of patients referred to a first referral urban hospital in a low‐income setting in Africa. We conducted a prospective descriptive cohort study from February 2016 to May 2017 in Maputo, Mozambique. Adult patients with systolic and diastolic blood pressure ≥180 mm Hg and/or ≥110 mm Hg, respectively, or any systolic blood pressure above 140 mm Hg and/or diastolic blood pressure above 90 mm Hg in the presence of target organ damage (with or without antihypertensive treatment) were submitted to detailed physical examination, funduscopy, laboratory profile, electrocardiography, and echocardiography. Six months after the occurrence of complications (stroke, heart failure, and renal failure), hospital admission and death were assessed. Overall, 116 hypertensive patients were recruited (mean age 57.5 ± 12.8 years old; 111[95.7%] black; 81[70%] female) of which 79 had severe hypertension. The baseline mean values recorded for systolic and diastolic blood pressure were 192.3 ± 23.6 and 104.2 ± 15.2 mm Hg, respectively. Most patients (93; 80.2%) were on antihypertensive treatment. Patients’ risk profile revealed dyslipidemia, obesity, and diabetes in 59(54.1%), 48(42.5%), and 23(19.8%), respectively. Target organ damage was found in 111 patients. The commonest being left atrial enlargement 91(84.5%), left ventricular hypertrophy 57(50.4%), hypertensive retinopathy 30(26.3%), and chronic kidney disease 27(23.3%). Major events during 6‐month follow‐up were hospitalizations in 10.3% and death in 8.6% of the patients. Worsening of target organ damage occurred in 10 patients: four stroke, two heart failure, and four renal damage. Patients with severe hypertension and target organ damage were young with high‐risk profile, low hypertension control, and high occurrence of complications during short‐term follow‐up. Efforts to improve high blood pressure control are needed to reduce premature mortality in this highly endemic poor setting.

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Several Conventional Risk Markers Suggesting Presence of Albuminuria Are Weak Among Rural Africans With Hypertension

Cited by 4 publications

References 18 publications

Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda

Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda

Albuminuria in Hypertensive Patients: Where the Choice of Antihypertensive Medications Matters:

Hypertension in a resource‐limited setting: Poor Outcomes on Short‐term Follow‐up in an Urban Hospital in Maputo, Mozambique

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