Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE study

Wachtell, Kristian; Palmieri, Vittorio; Olsen, Michael Hecht; Bella, Jonathan N.; Aalto, Tapio; Dahlöf, Björn; Gerdts, Eva; Wright, Jackson T.; Papademetriou, Vasilios; Mogensen, Carl Erik; Borch‐Johnsen, Knut; Ibsen, Hans; Devereux, Richard B.

doi:10.1067/mhj.2002.119895

Cited by 128 publications

(96 citation statements)

References 31 publications

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“…[103][104][105] There is a strong association between microalbuminuria and CVD in cross-sectional analysis. For example, microalbuminuria is associated with surrogates of CVD, such as increased intima-media thickness of the carotid artery in hypertensive subjects, 106 more frequent concentric LVH in hypertensive men, 104 abnormal left ventricular geometry and mass in subjects with hypertension and LVH, 107,108 and electrocardiographic evidence of myocardial ischemia. 109 Subjects with microalbuminuria also have a higher prevalence of clinical CVD than those without microalbuminuria.…”

Section: Proteinuriamentioning

confidence: 99%

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease

Sarnak¹,

Levey²,

Schoolwerth³

et al. 2003

Circulation

3,044

752

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Section: Proteinuriamentioning

confidence: 99%

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease

Sarnak¹,

Levey²,

Schoolwerth³

et al. 2003

Circulation

3,044

752

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“…Microalbuminuria is an independent risk factor for CVD, and cardiovascular and all-cause mortality in diabetics 3, 4 , hypertensives, 5,6,7,8 and the general population 4, 9, 10 , but it is unclear whether microalbuminuria adds to the prediction of CVD mortality in those with the metabolic syndrome. The Adult Treatment Panel III definition of metabolic syndrome is more widely used in the USA, therefore we used this definition.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Microalbuminuria Versus the Metabolic Syndrome as a Predictor of Cardiovascular Disease in Women and Men >40 Years of Age (from the Rancho Bernardo Study)

Jassal

Langenberg

Mühlen

et al. 2008

The American Journal of Cardiology

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To examine the sex-specific contributions of the metabolic syndrome and microalbuminuria to cardiovascular disease (CVD) and coronary heart disease (CHD) mortality in community-dwelling older adults, between 1992-1995, 869 women and 575 men aged 40-96 years (mean 71) completed questionnaires, physical examinations, and fasting laboratory tests. Participants were followed over an average of 8 years. CVD and CHD mortality were analyzed using Cox proportional hazards models. At baseline, 267 participants had the Adult Treatment Panel III metabolic syndrome, 151 had microalbuminuria, and 34 had both. During follow up, there were 180 CVD deaths, including 83 CHD deaths. In women, microalbuminuria was associated with a 2-fold increased risk of CVD and CHD mortality (p ≤ 0.01). Women with both microalbuminuria and the metabolic syndrome (n = 18) had a 3-fold increased risk of CVD mortality and a 5-fold increased risk of CHD mortality compared with women without either (n = 657). A significant interaction existed between microalbuminuria and the metabolic syndrome in the prediction of both CVD and CHD (p = 0.021). In men, neither the combination of the metabolic syndrome and microalbuminuria (n = 16), nor either alone, significantly increased the risk of CVD or CHD mortality. In conclusion, in this cohort, microalbuminuria and the metabolic syndrome together were a more powerful predictor of CVD mortality than either alone in women but not in men. Screening for microalbuminuria in older women may identify women at high risk for CVD mortality, beyond that conferred by risk factors included in the metabolic syndrome.

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“…1 Moreover, the association between UAE and increased CVD mortality in high-risk groups begins at levels of UAE below clinically defined thresholds for microalbuminuria. 1 Subclinical CVD, such as left ventricular (LV) hypertrophy [2][3][4][5][6] and increased carotid artery intima-media thickness (IMT), [7][8][9][10][11][12] has been associated with microalbuminuria among individuals at high risk for CVD. Whether the presence of increased UAE provides any additional predictive value for the presence of subclinical CVD in groups not at high risk aside from established, independent CVD risk factors remains unestablished.…”

mentioning

confidence: 99%

Urine Albumin Excretion and Subclinical Cardiovascular Disease

et al. 2005

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Abstract-We examined the association between urine albumin excretion (UAE) and common and internal carotid artery intima-media thickness (IMT), end-diastolic left ventricular (LV) mass, and coronary artery calcification (CAC) scores using data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of 6814 adults aged 45 to 85 years without clinical cardiovascular disease (CVD). The mean age of the MESA participants was 62.7 years, 47% were male, and 15% had diabetes mellitus (DM). Sex-specific spot urine albumin/creatinine ratios were used to define 4 UAE categories: normal, high normal, microalbuminuria, and macroalbuminuria. CAC scores were log-transformed after adding 1 to all scores. Key Words: cardiovascular diseases Ⅲ urine M icroalbuminuria, increased urine albumin excretion (UAE) below the detection of urinary dipstick measurement, strongly predicts cardiovascular disease (CVD) mortality in nondiabetic patients with established CVD. 1 Moreover, the association between UAE and increased CVD mortality in high-risk groups begins at levels of UAE below clinically defined thresholds for microalbuminuria. 1 Subclinical CVD, such as left ventricular (LV) hypertrophy 2-6 and increased carotid artery intima-media thickness (IMT), [7][8][9][10][11][12] has been associated with microalbuminuria among individuals at high risk for CVD. Whether the presence of increased UAE provides any additional predictive value for the presence of subclinical CVD in groups not at high risk aside from established, independent CVD risk factors remains unestablished. Coronary artery calcification (CAC) is highly correlated with the presence of coronary atherosclerotic plaque. [13][14][15] However, information on the association between CAC scores and UAE is currently limited.This study examined the association between UAE and several measures of subclinical CVD, including CAC scores, in a large multi-ethnic population without clinical CVD. We hypothesized that increased UAE is associated with subclinical CVD reflecting kidney damage caused by exposure to CVD risk factors, particularly diabetes mellitus (DM) and hypertension, and that these associations exist at UAE cutpoints below thresholds currently used to define microalbuminuria. An association between increased UAE and subclinical CVD in adults without clinical CVD may give further credence to using UAE to identify individuals who may benefit from aggressive risk factor intervention for the primary prevention of CV events.

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Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE study

Cited by 128 publications

References 31 publications

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease

Usefulness of Microalbuminuria Versus the Metabolic Syndrome as a Predictor of Cardiovascular Disease in Women and Men >40 Years of Age (from the Rancho Bernardo Study)

Urine Albumin Excretion and Subclinical Cardiovascular Disease

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