Development of Bacteriuria in a Hypertensive Population

A prospective study of the development of bacteriuria was undertaken in 800 hypertensive patients, using the catalase test on urine voided at each clinic visit as a screening technique. The prevalence of patients with positive catalase tests rose from 26% to 46% at the end of 7 years, with the prevalence of bacteriuria from subsequent urine cultures in catalase-positive patients similarly rising from approximately 6.5% to 13.2%. These data indicate that bacteriuria appears in a hypertensive population at a rate of approximately 1% yearly and support the concept that pyelonephritis is a predictable complication of hypertension rather than a primary etiologic factor. Whether the vulnerability to infection is greater than in a normotensive patient population was suggested but not clearly established by the data. The data did, however, demonstrate an increased morbidity and mortality from hypertension in hypertensive patients with urinary tract infection. The results also define the role of the catalase test as a procedure for rapid, inexpensive, and repeated screening of a large population for urinary tract infection.