Key result
In hypertensive patients at high cardiovascular risk, the presence of albuminuria was associated with a 9.9 g increase in left ventricular mass (95% CI 4.33-15.45; P=0.001), whereas eGFR was not.
Why the study?
Does the presence of albuminuria or eGFR predict left ventricular mass in patients with chronic systemic arterial hypertension?
Cohort (n=527)
No
Does the presence of albuminuria or eGFR predict left ventricular mass in patients with chronic systemic arterial hypertension?
Mean Difference: 9.9 (95% CI 4.33–15.45)
p-value: p=0.001
In hypertensive patients at high cardiovascular risk, the presence of albuminuria, but not eGFR, is a significant predictor of increased left ventricular mass.
Albuminuria may flag LV mass risk in high-CV-risk hypertension; leaves open whether it guides therapy or remodeling prevention.
BACKGROUND: Increased left ventricular mass (LVM) is known to predict cardiovascular morbidity and mortality. LVM is high in patients with advanced kidney disease. Our aim was to study the relationship between renal parameters and LVM in hypertensive subjects at high risk of cardiovascular disease. DESIGN: Cardiac MRI was performed in 527 patients participating in the single-centre SMART cohort study. Participants free from previous symptomatic coronary heart disease but with a history of hypertension were recruited. Subjects were screened for cardiovascular risk factors in a standardized way. Multivariable linear regression was used to study the relationship of both estimated glomerular filtration rate (eGFR) and presence of albuminuria with left ventricular mass. RESULTS: Mean LVM was 121 g for men (SD 26) and 87 g for women (SD 20). Mean eGFR was 82 mL/min/1.73 m(²) (SD 19). A total of 73 patients (14%) had albuminuria. After adjusting for known determinants of LVM (height, weight, sex and age) eGFR did not relate to LVM while presence of albuminuria did (mean change in LVM per 10 mL/min/1.73 m(2) change in eGFR 0.79 g, 95% CI -0.33 to 1.91, P = 0.17, mean change in LVM in presence vs. absence of albuminuria 9.9 g, 95% CI 4.33 to 15.45, P = 0.001). Additional adjustment for systolic blood pressure did not change results (B for eGFR 0.54, 95% CI -0.58 to 1.66, P = 0.35, B for albuminuria 9.09, 95% CI 3.57 to 14.60, P = 0.001). CONCLUSIONS: In this study in hypertensive patients with high vascular risk, albuminuria was related to increased LVM and eGFR was not.
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Beus et al. (2015) conducted a cohort in Chronic systemic arterial hypertension (n=527). Albuminuria vs. Absence of albuminuria was evaluated on Left ventricular mass (MD 9.9, 95% CI 4.33 to 15.45, p=0.001). In hypertensive patients at high cardiovascular risk, the presence of albuminuria was associated with a 9.9 g increase in left ventricular mass (95% CI 4.33-15.45; P=0.001), whereas eGFR was not.
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