Microalbuminuria as an overrated indicator of target organ damage in hypertension: a hospital based cross sectional study

Background: Hypertension is one of the leading causes of global burden of disease. Uncontrolled hypertension is associated with long term risk of damage to vital organs like brain, heart, kidney, blood vessels and eye i.e. Target Organ Damage (TOD). Medical scientists all over the world have been in search for an indicator which can accurately predict TOD. It is accepted that Microalbuminuria (MA) represents a more generalised vascular problem, not only confined to renal microcirculation. MA is found in a significant proportion of non-diabetic population, particularly in association with hypertension and is a predictor of cardiovascular disease. The objective of the study was to evaluate MA in hypertension and its correlation with TOD. Methods: A Hospital based cross sectional study carried out in the department medicine of central referral hospital, a well-equipped tertiary care hospital in East Sikkim, Gangtok. 200 patients were recruited fulfilling the inclusion criteria of pre hypertension, stage 1 & 2 hypertension as defined by JNC 7 report. Patients with secondary hypertension, DM, ESRD & hyperuricemia were excluded. MA was estimated by Immunoturbidimetry. Results: MA is associated with all TOD but significant correlation was found only with retinopathy. Out of 200 study subjects, 90 (45%) subjects had retinopathy out of which 54 (60%) had MA and 36 (40%) did not have MA. (P <0.0001) Conclusion: MA has established its position in DM where it indicates early end organ damage and heralds cardiovascular risk. Its role as a reliable indicator of TOD in non-diabetic hypertensives needs further evaluation.