Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension

OBJECTIVE: We tested the hypothesis that qualitative microalbuminuria (MAU) screening in a practice setting would identify non-diabetic hypertensive patients at high risk of developing cardiovascular disease. DESIGN: We enrolled general practitioners throughout Germany, who obtained histories, physical examinations, and routine laboratory values as clinically indicated on treated or non-treated hypertensive, non-diabetic patients. MAU was measured with a albumin-sensitive, immunoassay test strip. We studied 11 343 non-diabetic hypertensive patients. RESULTS: The patients' mean age was 57 years, 51% were men and mean hypertension duration was 69 months. Twenty-five per cent had coronary artery disease, 17% had left ventricular hypertrophy, 5% had had a stroke, and 6% had peripheral vascular disease. MAU was present in 32% of men and 28% of women (P < 0.05). In patients with MAU, 31% had coronary artery disease, 24% had left ventricular hypertrophy, 6% had had a stroke, and 7% had peripheral vascular disease. In patients without MAU, these rates were 22%, 14%, 4%, and 5% respectively: lower in every category (P < 0.001). Further, in patients with coronary artery disease, left ventricular hypertrophy, stroke, and peripheral vascular disease, MAU was significantly greater than in patients who did not have these complications (P < 0.001). MAU increased with age, severity of hypertension and duration of hypertension, was associated with higher plasma creatinine values, and was more common in patients with hyperlipidemia (P < 0.05). CONCLUSION: On the basis of our survey, we conclude that qualitative MAU determinations identify hypertensive patients with particular cardiovascular risk in a practice setting.