Awareness and behaviour of European physicians in relation to microalbuminuria and organ damage: an ESH-endorsed survey

Haller, Hermann; Menne, Jan; Mancia, Giuseppe

doi:10.1097/hjh.0b013e32833cfd40

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Moreover, the above rates are much lower than that observed in an earlier European survey, in which 250 French physicians (GPs, cardiologists and diabetologists) were declared to assess 28.5% of their patients (not described in the latter study) for microalbuminuria [11]. It should be highlighted however that these latest modalities as well as carotid intima-media thickness are not currently recommended by French guidelines, and all but microalbuminuria (which may be investigated, however, in patients with a low or moderate cardiovascular risk according to the French guidelines [5]) are therefore not currently reimbursed by healthcare coverage, thereby limiting their implementation.…”

Section: Cost Analysescontrasting

confidence: 66%

Target organ damage assessment in French hypertensive patients without established cardiovascular or renal disease

Rossignol

Hosseini

Tropeano

et al. 2013

Journal of Hypertension

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Section: Cost Analysescontrasting

confidence: 66%

Target organ damage assessment in French hypertensive patients without established cardiovascular or renal disease

Rossignol

Hosseini

Tropeano

et al. 2013

Journal of Hypertension

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“…Unfortunately, the powerful predictive power of renal abnormalities is not yet fully exploited in clinical practice, at least in Europe, as confirmed by a recent survey carried out by the ESH [29]. …”

Section: The Kidney Message On Cardiovascular Riskmentioning

confidence: 99%

Global Cardiovascular Risk Assessment in the Management of Primary Hypertension: The Role of the Kidney

Viazzi

Leoncini

Pontremoli

2013

International Journal of Hypertension

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The knowledge of each patient's global risk profile is a prerequisite for effective therapeutic strategies in primary hypertension. Detecting the presence of subclinical organ damage at the cardiac, vascular, and renal levels is key for stratifying cardiovascular risk and may also be helpful in choosing antihypertensive agents and in monitoring the effectiveness of treatment. A systematic, in-depth search for subclinical organ damage, however, may be difficult to carry out because of logistic and economic problems related to the high prevalence of hypertension in the population. Renal abnormalities such as microalbuminuria and reduction in glomerular filtration rate have proven to be powerful predictors of cardiovascular and renal outcome. Thanks to their relatively low cost and wide applicability, more widespread use of these tests in the diagnostic workup will help detect subsets of patients at greater risk for whom additional preventive and therapeutic treatment is advisable.

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“…Only 42.5% of those diabetologists and 35.5% of the cardiologists had examined MAU in their type 2 DM and hypertensive patients, which suggests that MAU is under valuated as a risk factor for cardiovascular damage. Actions to raise awareness and further teaching towards the appropriate use of MAU as a diagnostic tool are certainly needed [9].…”

Section: Introductionmentioning

confidence: 99%

Microalbuminuria in White and Black Hypertensive Nondiabetic Brazilian Patients

Belo¹,

Machado²,

Figueiredo³

et al. 2014

WJCD

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Microalbuminuria (MAU) is a predictor of cardiovascular mortality in patients with diabetes mellitus (DM) and hypertension (HTN) and also in an unselected population. The American Diabetes Association (ADA) and the National Kidney Foundation (NKF) define MAU as an albumin/creatinine ratio (ACR) between 30 and 300 µg/mg in both men and women. Aim: To evaluate the possible relationship among MAU, HTN and gender and ethnicity in Brazilian nondiabetic primary hypertensive patients. Design: Population-based study. Participants: Ninety-eight men and women, seventy-two black and twenty-six white nondiabetic primary hypertensive patients aged 20 years or older were selected. Forty healthy individuals, paired according to age, gender, and ethnics were used as controls. Methods: Early-morning midstream urine was used. Urinary albumin was spectrophotometrically measured with Coomassie Brillant Blue G-250. Creatinine was determined by a method based on Jaffe's reaction. ACR (µg albumin/mg creatinine) was calculated. Data are expressed as medians. Results: ACR level was significantly higher in 98 hypertensive patients (38.00) than in 40 control individuals (23.00) (P < 0.001). ACR level was significantly higher in 48 hypertensive male (46.00) than in 50 hypertensive female (34.00) (P = 0.008). No significant effect of ethnicity on ACR levels between 26 hypertensive Whites (35.50) and 72 hypertensive Blacks (38.00) was observed (P = 0.978). Conclusions: The ACR level, significantly higher in hypertensive patients than in control individuals, supports data from the literature. To our knowledge, this is the first study demonstrating that the ACR level is significantly higher in men than in women. The lack of an ethnicity effect supports what was already asserted, namely, that in Brazil, at an individual level, color, as determined by physical evaluation, is a poor predictor of genomic African * Corresponding author, retired professor. A. A. Belo et al. 237 ancestry, as estimated by molecular markers.

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Awareness and behaviour of European physicians in relation to microalbuminuria and organ damage: an ESH-endorsed survey

Abstract: Physicians have an incomplete understanding that MAU is not only a risk factor but also an important diagnostic tool for renal and cardiovascular damage. There are methodological inconsistencies in the way that MAU is currently assessed and standardization is required.

Cited by 7 publications

References 21 publications

Target organ damage assessment in French hypertensive patients without established cardiovascular or renal disease

Target organ damage assessment in French hypertensive patients without established cardiovascular or renal disease

Global Cardiovascular Risk Assessment in the Management of Primary Hypertension: The Role of the Kidney

Microalbuminuria in White and Black Hypertensive Nondiabetic Brazilian Patients

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