Microalbuminuria, left ventricular mass and ambulatory blood pressure in essential hypertension.

Microalbuminuria (MALB) is a potential marker of risk in essential hypertension. Previously we describe a relationship between MALB and left ventricular mass (LVM) independent of office BP values. To assess if the relationship between MALB and LVM is independent of a more representative BP values as such the ambulatory BP. Patients with essential hypertension, aged 25 to 50 years old, never treated with antihypertensive drugs, were included in the study. The inclusion criteria was: a) absence of diabetes, renal disease or urinary tract infection: b) echocardiography suitable for measurement of LVM; c) Urinary albumin excretion (UAE) was estimated in urine of 24 hour in two separated days and d) good quality ambulatory blood pressure monitoring during 24 hours. LVM was calculated by the Devereaux formula and refered to height (LVMI g/m). UAE was measured using a immunonephelometric assay (Behring Institute) and MALB was considered when UAE≥30mg/24h in the two days. AMBP was performed using an oscilometric device (Spacelabs 90202 or 90207) during a regular working day. Readings were programmed every 20 min between 6 am to midnight and thereafter every 30 min. Mean of 24 hours, awake and sleep periods for systolic and diastolic blood pressure were calculated. One hundred and fifthy one patients (96 male, mean age 37±8 yr, BMI 27.7±3.7 g/m2) were included. The mean values of UAE was 30.1±52.3 mg/24h and the LVMI 140.6±44.1 g/m. The percentage of MALB was 28% and LV hypertrophy 34%. A significant relationship between UAE and LVMI was observed independent of diastolic ambulatory BP, age and sex. The relationship is show in the figure. Patients with essential hypertension and MALB had higher LV mass at the same diastolic BP values. Assessment of MALB can be useful for stratification of risk on hypertensives