No abstract

No abstract

Blood pressure (BP) control rates are known to be insufficient worldwide. Although some improvement has occurred over time, 1 the lack of BP control has a prevalence of approximately 60% in European countries 2 and >50% in the United States. 1 As regards subclinical target organ damage, left ventricular hypertrophy is associated with worse BP control, 3 and the relationship between urinary albumin excretion (UAE) and BP levels has also been widely explored. Thus, analyses of the data from the National Health and Nutrition Examination Survey have shown an association between microalbuminuria and uncontrolled office BP in a hypertensive population when the cutoff of 30 mg/g of UAE to define microalbuminuria was used, 1,4 regardless of the degree of renal function. On the other hand, several studies have shown the prognostic value of albuminuria for overall mortality and cardiovascular and renal morbidity at levels of UAE well below the cutoff point of 30 mg/g. [5][6][7] Recently, the meta-analysis by Hallan et al. 7 that evaluated large cohorts of general population, vascular high-risk patients, and individuals with chronic kidney disease showed that the association of UAE with end-stage renal disease and mortality risks was linear with no threshold. In agreement with this, the division of normoalbuminuria into 2 different categories-optimal UAE (<10 mg/g) and high-normal UAE (10-29 mg/g)-has been proposed. 8 However, it is unclear whether the relationship between BP and UAE is different between patients with optimal and high-normal UAE. Accordingly, we hypothesize that UAE could be associated with office BP control at levels lower than those that define microalbuminuria (i.e., 30 mg/g) in patients with treated hypertension. Although elevated urinary albumin excretion (UAE) is associated with cardiovascular prognosis and high blood pressure (BP), it is unknown whether differences in BP control could also exist between patients with different grades of UAE, even in the normal range. We sought to explore the association between different levels of UAE and BP control in treated hypertensive patients.

No abstract

No abstract