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- Title
F015: Microalbuminuria, pulse pressure and carotid atherosclerosis in essential hypertensive patients.
- Authors
Dell'Omo, G.; Giannini, D.; Di Bello, V.; Bertini, A.; Balbarini, A.; Pedrinelli, R.; Mariani, M.
- Abstract
Background: Because of its association with atherosclerotic complications, microalbuminuria (MA, UAE≥15 μg/min) in non diabetic essential hypertensive subjects is frequently postulated to reflect directly a systemic alteration in capillary permeability due to atherosclerosis.Methods: Urinary albumin excretion (UAE, the mean of three overnight collections, nephelometry), common carotid intima-media thickness (IMT, the mean of 6 right and left far wall measurements, high resolution ultrasonography), an accepted surrogate measure of systemic atherosclerosis, BP (indirect method), left ventricular mass index (LVMI, echocardiography), lipids were measured in 141 untreated, normoglycemic hypertensive males (153±15/95±11 mmHg) with normal cardiac and renal function.Results: (Means±SD or Medians & Range): MA [UAE: 34 (15-220) μg/min] was present in 41 patients characterised by somewhat older age (57±10 vs 53±13, p=0.04), greater IMT (0.99±0.4 vs 0.83±0.3, p=0.006) and LVMI (160±36 vs 147±30 g/m, p=0.03), reduced HDL cholesterol (40±11 vs 44±14 mg/dl, p=0.1). Systolic (S) BP (160±14 vs 150±15 mmHg, p<0.001) was higher, diastolic (D) BP superimposable (95±11 vs 94±9 mmHg), and, as a consequence, pulse pressure (PP, 65±13 vs 55±15 mmHg p<0.001) elevated in the presence of MA. IMT and PP showed a strong positive association (r=0.38, p<0.001); both (r=0.22, p=0.008, r=0.39, p<0.001, respectively) correlated with UAE in univariate analyses. In a multivariate stepwise logistic regression analysis, relative risk of MA increased with widening PP values (1.53/10 mmHg PP increase, 95% CI: 1.24-1.88, p<0.001), increasing LVMI (1.13/10 10 g/m increase, 95% CI: 1.008-1.26, p=0.03) and active smoking (2.4, 95% CI: 1.003-5.57, p=0.049); IMT and HDL cholesterol showed no independent influence.Conclusions: UAE levels do not appear to reflect directly the presence of atherosclerosis as assessed by carotid ultrasonography in non diabetic hypertensive subjects. Rather, wider PP, an index of the pulsatile hemodynamic load and a primary cardiovascular risk factor, greater LVMI and smoking habits may represent chains in the link between the two.Am J Hypertens (2000) 13, 103A-103A; doi:S0895-7061(00)00514-8
- Publication
American Journal of Hypertension, 2000, Vol 13, p103A
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1016/S0895-7061(00)00514-8