Key result
Baseline urinary albumin excretion in the upper two-thirds of the normal range was associated with a 3-fold increased risk of developing microalbuminuria at 1 year in hypertensive patients.
Why the study?
What are the risk factors for progression to microalbuminuria in normoalbuminuric hypertensive patients with high cardiovascular risk?
Cohort (n=173)
What are the risk factors for progression to microalbuminuria in normoalbuminuric hypertensive patients with high cardiovascular risk?
Effect estimate: OR 3
p-value: p=<0.05
In normoalbuminuric hypertensive patients, higher baseline urinary albumin excretion and poor blood pressure and lipid control are associated with an increased risk of developing microalbuminuria at 1 year.
May warrant closer monitoring in high-normal albuminuric hypertensives; leaves open whether intervention alters progression.
AIMS: To investigate risk factors for progression to microalbuminuria in normoalbuminuric hypertensive patients. METHODS: In a longitudinal study, 173 previously treated normoalbuminuric hypertensive patients with high cardiovascular risk (70% diabetics) were evaluated at study entry and after 12 months. Levels of urinary albumin excretion (UAE; study entry and end of study) were compared between patients remaining normoalbuminuric (RNA) and progressors to non-normoalbuminuric (NNA) levels. RESULTS: Out of 173 patients (59 +/- 13 years), 12% evolved to NNA levels. At baseline, NNA and RNA groups did not differ in age, sex, diabetes, lipids, blood pressure (BP), drug therapy, or glomerular filtration rate. In comparison with RNA patients, the NNA group showed higher hypertension duration, greater UAE and percentage of patients with UAE >or=10 mg/g creatinine (76.2 vs. 45.4%) at study entry and higher BP levels (158/92 +/- 25/10 vs. 143/83 +/- 20/12 mm Hg) at study end (all p < 0.05). Logistic regression analysis identified absolute UAE values at study entry and study end variation of BP and cholesterol as independent contributors to the increase in the log odds of developing microalbuminuria. CONCLUSIONS: Normoalbuminuric hypertensives with UAE within the upper two thirds of normal range are 3 times as likely to develop microalbuminuria after 1 year. A poor BP and lipid control are also associated with increased risk of microalbuminuria.
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Cotter et al. (2009) conducted a cohort in Normoalbuminuric hypertension with high cardiovascular risk (n=173). Baseline urinary albumin excretion (UAE) was evaluated on Progression to microalbuminuria (non-normoalbuminuric levels) (OR 3, p=<0.05). Baseline urinary albumin excretion in the upper two-thirds of the normal range was associated with a 3-fold increased risk of developing microalbuminuria at 1 year in hypertensive patients.
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