Microalbuminuria, LVH, and CAD in hypertensive patients
Microalbuminuria, LVH, and CAD in hypertensive patients

Summary/Abstract: Epidemiologic and experimental data show that microalbuminuria is associated with high incidence and increased risk for cardiovascular mortality among individuals with hypertension in whom it is linked to an increased atherogenic risk pattern, especially when accompanied by other target organ damage. Microalbuminuria is also independently correlated with cardiovascular morbidity even after adjusting for known cardiovascular risk factors. 157 eligible patients with pre-existent hypertension, admitted in the Institute of Cardiovascular Diseases from January 2012 to December 2013, were screened for microalbuminuria. A first-morning urine sample was analysed by immunoturbidimetry, and values between 20-200 mg/l accounted for microalbuminuria. Based on their medical history, clinical and biochemical assessment, as well as diagnostic procedures (coronarography), the patients were divided into two groups : with coronary artery disease (CAD) (n=109) or without CAD (n=48). Left ventricular hypertrophy (LVH) was assessed by ecocardiography. 51.6% of the total study population had microalbuminuria, without significant prevalence rates between the group with CAD (51.4%) and without CAD (47.9%). Compared to subjects without CAD, patients with CAD had a greater prevalence of LVH (56.9% vs. 29.2%, p=0.001) and higher values of albuminuria (median 20.79 mg/l vs.18.76 mg/l, p=0.047). In a univariable linear regression, microalbuminuria positively correlated with the presence of CAD (b=0.194±0.001, p=0.015) and LVH (b=0.311±0.001, p<0.001). A further logistic regression showed that increasing albuminuria rates influence the presence or absence of LVH (Exp(B)=1.025, p=0.001), as well as the presence or absence of CAD (Exp(B) =1.019, p=0.023). Because of its high cost-effectiveness and wide availability, microalbuminuria is recommended for the evaluation of hypertensive patients, in order to detect subclinical target organ damage that increases the cardiovascular risk level, and to adjust therapeutic strategy.

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