Key result
Higher central diastolic blood pressure was significantly associated with microalbuminuria in essential hypertension (OR 1.017), and its combination with plasma aldosterone and uric acid yielded an AUC of 0.709 for predicting microalbuminuria.
Why the study?
To investigate the development of microalbuminuria in essential hypertension by assessing its association with central blood pressure, direct renin concentration, plasma aldosterone, and uric acid.
Case-Control (n=404)
No
Odds Ratio: 1.017 (95% CI 1.002–1.032)
p-value: p=0.027
The combination of central diastolic blood pressure, plasma aldosterone, and uric acid provides a reliable predictive model for the development of microalbuminuria in patients with essential hypertension.
Observed associations of microalbuminuria with central BP and aldosterone in hypertension warrant caution; leaves open causal role pending prospective validation.
OBJECTIVE: To study the development of microalbuminuria (MAU) in essential hypertension (EHT), we investigated the association of MAU with central blood pressure (CBP), direct renin concentration (DRC), plasma aldosterone (PA), and uric acid (UA). METHOD: We determined 24 h-urinary albumin excretion (24 h-UAE) in patients with EHT who were hospitalized at TEDA International Cardiovascular Hospital from June 2020 to May 2022. We defined MAU as 24 h-UAE in the range of 30 mg/24 h to 300 mg/24 h. Univariate and multivariate analyses were conducted to determine the associations of MAU with CBP, DRC, PA, and UA in EHT, considering demographic and clinical information. We also plotted receiver operating characteristic curves (ROCs) for predicting MAU using these results. RESULTS: More than a quarter of patients (26.5%, 107/404, 95% CI: 22.2-31.1%) were diagnosed with MAU in EHT. A higher body mass index (BMI), longer duration of hypertension, and higher severity were associated with MAU. Also, nearly 10% more creatinine levels were recorded in the MAU group than in the control group (69.5 ± 18.7 µmol/L vs. 64.8 ± 12.5 µmol/L, P = 0.004). The increase was also observed for PA (15.5, 9.7-20.6 ng/dL vs. 12.3, 9.0-17.3 ng/dL, P = 0.024) and UA (419.8 ± 105.6 µmol/L vs. 375.1 ± 89.5 µmol/L, P < 0.001) in the MAU group compared to that in the control group. Several variables were associated with MAU, including central diastolic blood pressure (CDBP) (OR = 1.017, 95% CI: 1.002-1.032, P = 0.027), PA (OR = 1.043, 95% CI: 1.009-1.078, P = 0.012) and UA (OR = 1.005, 95% CI: 1.002-1.008, P < 0.001). For MAU prediction, the area under the curve (AUC) was 0.709 (95% CI: 0.662-0.753; P < 0.001) when CDBP, PA, and UA were used in combination, and the optimal probability of the cut-off value was 0.337. CONCLUSION: We found that CDBP, PA, and UA, used for MAU prediction, might be associated with its development during EHT.
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Li et al. (2023) conducted a case-control in Essential hypertension (n=404). Central diastolic blood pressure (CDBP) vs. Patients without microalbuminuria was evaluated on Microalbuminuria (MAU) (OR 1.017, 95% CI 1.002-1.032, p=0.027). Higher central diastolic blood pressure was significantly associated with microalbuminuria in essential hypertension (OR 1.017), and its combination with plasma aldosterone and uric acid yielded an AUC of 0.709 for predicting microalbuminuria.
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