Positive correlation between hypertensive retinopathy and albuminuria in hypertensive adults

Abstract

Purpose We investigated the association between albuminuria and hypertensive retinopathy (HR) in hypertensive adults. Methods This was a cross-sectional subgroup analysis of data from the China Stroke Primary Prevention Trial. We enrolled 2,964 hypertensive adults in this study. Keith-Wagener-Barker stages was used to assess HR. The urinary albumin to creatinine ratio (UACR) was calculated to evaluate albuminuria. Results HR was found in 76.6% (n = 2, 271) of the participants, albuminuria was found in 11.1% (n = 330). The UACR levels were significantly higher in subjects with HR than in those without HR (grade 1, β = 1.42, 95% confidence intervals [CI]: -0.12, 2.95, p = 0.070; grade 2, β = 2.62, 95% CI: 0.56, 4.67, p = 0.013; grade 3, β = 5.17, 95% CI: 1.13, 9.20, p = 0.012). In the subgroup analyses, the association between HR and UACR was stronger in current smokers (p for interaction = 0.014). The correlation between HR grades 1 and 2 and UACR was stronger in subjects with higher triglyceride levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglycerides levels (< 1.7 mmol/L, p for interaction = 0.023). The odds of albuminuria were significantly higher in subjects with HR than in those without HR (grade 1, odds ratio [OR] = 1.57, 95% CI: 1.08, 2.29, p = 0.019; grade 2, OR = 2.02, 95% CI: 1.28, 3.18, p = 0.002; grade 3, OR = 2.12, 95% CI: 0.99, 4.55, p = 0.053). In the subgroup analyses, the association between HR grades 1 and 2 and albuminuria was stronger in subjects with higher triglycerides levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglyceride levels (< 1.7 mmol/L, p for interaction = 0.014). Conclusion HR was positively correlated with albuminuria in hypertensive Chinese adults. This correlation was more remarkable when the population was stratified by triglycerides levels and smoking status. HR can be used as an indicator of early renal injury.

Association between urinary albumin-to-creatinine ratio within the normal range and insulin resistance and prediabetes among US adults: a population-based study

“…This nding aligns with prior research on the impact of smoking status on the association of UACR with other diseases. For instance, in the study by Li et al investigating the link between hypertensive retinopathy and albuminuria in patients with hypertension, the association of UACR with hypertensive retinopathy was found to be stronger in current smokers compared to nonsmokers, with a P value for interaction of 0.014 [27]. The in uence of smoking on these associations can be attributed to the detrimental effects of smoking on the body.…”

“…Fourthly, the de nition of IR in this study is based on HOMA-IR, which is not a direct indicator for determining IR. Research using direct measure methods to determine IR, such as hyperinsulinemic-euglycemic clamp [27], may yield more accurate information. Lastly, our analysis was based on the US population, therefore, our conclusions should be treated with caution when extrapolating to other populations.…”

Albuminuria: An Underappreciated Risk Factor for Cardiovascular Disease

“… 67 Even in the absence of diabetes, patients with retinopathy have higher albuminuria levels than those without, as seen in 2271 patients with hypertension. 68 The association between microvascular disease and albuminuria is also seen in relation to diabetic peripheral neuropathy, where a change in UACR ≥30% may indicate a risk for new‐onset diabetic peripheral neuropathy. 69 …”

Seltene vaskuläre Erkrankungen der Netzhaut – Teil 1

“…Patienten mit einer hypertensiven Retinopathie haben häufiger Nierenfunktionsstörungen und ein erhöhtes Risiko für kardiovaskuläre, zerebrovaskuläre Erkrankungen sowie Demenz 5 , 12 , eine Abklärung dieser Risiken ist daher empfehlenswert.…”