Association between urinary albumin excretion and both central and peripheral blood pressure in subjects with insulin resistance

Oliveras, Anna; García‐Ortiz, Luis; Segura, Julián; Banegas, José R.; Claros, Nieves Martell; Vigil, Luis; Suárez, C. Roldán; Gómez‐Marcos, Manuel A.; Abad-Cardiel, M.; Vázquez, Susana; Cruz, Juan; Franklin, Stanley S.; Ruilope, Luís M.; Sierra, Alejandro de la

doi:10.1097/hjh.0b013e32835ac7b5

Cited by 19 publications

(18 citation statements)

References 36 publications

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“…Interestingly it was noted that the association was non-linear, suggesting a threshold above which the hemodynamic effects of elevated PP exerts a renal effect. Similar findings have been shown in other studies [40,41]. It has been suggested that elevated PP may result in excessive penetration of pulsatile energy to the kidney, ultimately damaging the renal microvasculature and leading to wall hypertrophy, as seen in renal biopsies of mildly proteinuric hypertensive patients [42].…”

Section: Nephropathysupporting

confidence: 64%

Arterial stiffness in diabetes mellitus

2015

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Section: Nephropathysupporting

confidence: 64%

Arterial stiffness in diabetes mellitus

2015

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“…Goupil et al also found that microalbuminuria and early chronic kidney disease were not associated with office central BP [5]. A previous study from our group showed similar correlation of microalbuminuria with office central BP and office brachial BP [18]. Finally, in a Chinese community, Fan et al found that, compared with office brachial SBP, office central SBP was a stronger predictor for kidney function decline [6].…”

Section: Discussionmentioning

confidence: 88%

“…Their development is based on the premise that central or aortic BP reflects the true load on the target organ. In fact, several studies have suggested that central BP is associated with the macrovascular damage, specifically cardiac and carotid damage, but is not so closely related to the microvascular lesion [2, 4, 6, 15-18]. Kollias et al analyzed four studies that showed similar correlations of urine albumin excretion with brachial SBP and central BP (three in an office setting and one with ABPM) [2].…”

Section: Discussionmentioning

confidence: 99%

Cuff-Based Oscillometric Central and Brachial Blood Pressures Obtained Through ABPM are Similarly Associated with Renal Organ Damage in Arterial Hypertension

Fernández-Llama

Pareja

Yun

et al. 2017

Kidney Blood Press Res

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Background/Aims: Central blood pressure (BP) has been suggested to be a better estimator of hypertension-associated risks. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of renal organ damage in hypertensive patients. Methods: Brachial and central (calculated by an oscillometric system through brachial pulse wave analysis) office BP and ambulatory BP monitoring (ABPM) data and aortic pulse wave velocity (PWV) were measured in 208 hypertensive patients. Renal organ damage was evaluated by means of the albumin to creatinine ratio and the estimated glomerular filtration rate. Results: Fifty-four patients (25.9%) were affected by renal organ damage, displaying either microalbuminuria (urinary albumin excretion ≥30 mg/g creatinine) or an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m². Compared to those without renal abnormalities, hypertensive patients with kidney damage had higher values of office brachial systolic BP (SBP) and pulse pressure (PP), and 24-h, daytime, and nighttime central and brachial SBP and PP. They also had a blunted nocturnal decrease in both central and brachial BP, and higher values of aortic PWV. After adjustment for age, gender, and antihypertensive treatment, only ABPM-derived BP estimates (both central and brachial) showed significant associations with the presence of renal damage. Odds ratios for central BP estimates were not significantly higher than those obtained for brachial BP. Conclusion: Compared with peripheral ABPM, cuff-based oscillometric central ABPM does not show a closer association with presence of renal organ damage in hypertensive patients. More studies, however, need to be done to better identify the role of central BP in clinical practice.

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“…The pooled correlations between cPP and pPP with cfPWV ( r = 0.41 and 0.35 for cPP and pPP, respectively) were similar to the findings of the present study ( r = 0.41 and 0.40 for cPP and pPP, respectively), but the correlation coefficients were higher for ACR and lower for carotid IMT in the present study. Some studies show that urinary albumin excretion assessed by 24-h urine protein or ACR [3,15] have similar correlation with central and peripheral pressure. In our study, we found that cPP was more closely correlated with urinary albumin excretion assessed by ACR than pPP.…”

Section: Discussionmentioning

confidence: 99%

“…Recent advances in blood pressure measurement have enabled the combination of the conventional brachial sphygmomanometer with a peripheral pulse waveform to estimate central aortic pressure (AP) non-invasively [2]. A number of studies have shown that central aortic blood pressure could better reflect the load on the heart and central vasculature and organs [3,4]. Central aortic pulse pressure (PP) showed higher correlation with carotid atherosclerosis and the incidence of cardiovascular events than peripheral PP [5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Association of Haemodynamic Indices of Central and Peripheral Pressure with Subclinical Target Organ Damage

Zuo

Chu

Tan

et al. 2017

Pulse

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Background: Central aortic pressure has often been shown to be more closely associated with markers of vascular function and incidence of cardiovascular events compared to peripheral pressure. However, the potential clinical use of central aortic or peripheral haemodynamic indices as markers of target organ damage (TOD) has not been fully established. Methods: We evaluated associations of TOD with central aortic and peripheral haemodynamic indices (central aortic [cPP] and peripheral pulse pressure [pPP], central aortic augmentation index, and central and peripheral waveform factor) in 770 hospital inpatients (age 60 ± 10 years, 473 males) with primary hypertension. TOD was quantified in terms of arterial stiffness as measured by carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (IMT), and urine albumin-to-creatinine ratio (ACR). Subclinical TOD was defined as carotid IMT >0.9 mm, urine ACR >3.5 mg/mmol in females and >2.5 mg/mmol in males and/or cfPWV >12 m/s. Results: Both cPP and pPP showed significant correlation with cfPWV (r = 0.41 vs. 0.40; p < 0.01), ACR (r = 0.24 vs. 0.27; p < 0.01) and carotid IMT (r = 0.14 vs. 0.15; p < 0.01). Each SD increase in pPP and cPP was associated with increased risk of cfPWV >12 m/s (odds ratio [OR] = 2.7 and 2.9 for pPP and cPP, respectively), ACR >2.5 mg/mmol (OR = 1.2 and 1.4, respectively), and carotid IMT >0.9 mm (OR = 1.46 and 1.53, respectively). Compared to pPP, cPP had higher predictive power for TOD for age ≥60 years (OR = 3.07, p < 0.001). Conclusions: Although both pPP and cPP show an association with TOD in a hypertensive population, cPP provides additional information beyond pPP associated with TOD in a hypertensive cohort. Central aortic haemodynamic indices as potential biomarkers of subclinical TOD need to be validated by further prospective studies.

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Association between urinary albumin excretion and both central and peripheral blood pressure in subjects with insulin resistance

Abstract: Although cBP is related with UAE, this relationship is not superior to that of office peripheral BP.

Cited by 19 publications

References 36 publications

Arterial stiffness in diabetes mellitus

Arterial stiffness in diabetes mellitus

Cuff-Based Oscillometric Central and Brachial Blood Pressures Obtained Through ABPM are Similarly Associated with Renal Organ Damage in Arterial Hypertension

Association of Haemodynamic Indices of Central and Peripheral Pressure with Subclinical Target Organ Damage

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