Microalbuminuria is associated with unfavourable cardiac geometric adaptations in essential hypertensive subjects

Abstract

We sought in this study to examine the relationship between microalbuminuria and cardiac geometry since a slight increased urinary albumin excretion (UAE) and increased left ventricular (LV) mass have both been identified as predictors of cardiovascular events in hypertensive subjects. For this purpose, microalbuminuria was determined in three non-consecutive 24-h urine samples as UAE of 20-200 mg/24 h in a group of 249 untreated hypertensive subjects. Echocardiographic classification of patients into LV geometric patterns was based on relative wall thickness values and on genderspecific values for LV mass index (LVMI). The group of patients with microalbuminuria (n = 119) was matched for age, sex, body mass index, smoking status and plasma cholesterol level with the group of patients without microalbuminuria (n = 130). Subjects with microalbuminuria had significantly increased LVMI (111 vs 90 g/m 2 , P Ͻ 0.0001), relative wall thickness (0.46 vs 0.41, P Ͻ 0.001) and office systolic and diastolic blood pressure (161 vs 148 and 101 vs 97 mmHg, respectively, P Ͻ 0.005). For the pooled population, UAE was posi-

Left Ventricular Concentric Geometry as a Risk Factor in Gestational Hypertension

“…Recent reports have evidenced that in essential hypertension, patients with high-normal albuminuria had a greater RWT and more frequent concentric left ventricular hypertrophy, 24 and that the prevalence of concentric left ventricular hypertrophy was significantly higher in microalbuminuric compared with normoalbuminuric subjects. 25 Our data suggest that concentric geometry in mild GH women might be linked to the occurrence of proteinuria, because 12 out of the 14 patients with preeclampsia had a concentric geometry before its appearance.…”

The controversial role of serum uric acid in essential hypertension: relationships with indices of target organ damage

“…[29][30][31][32][33][34] In contrast, the independent cardiovascular prognostic role of SUA is still debatable since in the majority of studies it is suggested that it might be the result of complex interactions with other well-defined risk markers. In line with the previous data, Alderman et al 35 found that SUA levels were positively associated with future cardiovascular adverse events in patients with essential hypertension, although this association was not statistically significant in both the white population and in subjects without a history of previous cardiovascular disease.…”

Urine Albumin Excretion and Subclinical Cardiovascular Disease

“…1 Moreover, the association between UAE and increased CVD mortality in high-risk groups begins at levels of UAE below clinically defined thresholds for microalbuminuria. 1 Subclinical CVD, such as left ventricular (LV) hypertrophy [2][3][4][5][6] and increased carotid artery intima-media thickness (IMT), [7][8][9][10][11][12] has been associated with microalbuminuria among individuals at high risk for CVD. Whether the presence of increased UAE provides any additional predictive value for the presence of subclinical CVD in groups not at high risk aside from established, independent CVD risk factors remains unestablished.…”