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Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients

2004; Wiley; Volume: 256; Issue: 1 Linguagem: Inglês

10.1111/j.1365-2796.2004.01338.x

1365-2796

Giuseppe Mulè, Santina Cottone, Anna Vadalà, Vito Volpe, Giovanni Mezzatesta, R. Mongiovì, G. Piazza, Emilio Nardi, Giuseppe Andronico, Giovanni Cerasola,

Diabetes, Cardiovascular Risks, and Lipoproteins

Abstract. Objectives. To evaluate, in a group of nondiabetic essential hypertensive patients with normal renal function, the relationship between albumin excretion rate (AER) and carotid‐femoral pulse wave velocity (PWV), as an index of aortic stiffness. Design. Cross‐sectional study. Setting. Outpatient hypertension clinic. Subjects. Seventy patients with mild‐to‐moderate essential hypertension, aged 42 ± 8 years, never pharmacologically treated. All subjects underwent routine laboratory tests, 24‐h ambulatory blood pressure (BP) monitoring, measurement of carotid‐femoral PWV, by means of a computerized method, and AER. Results. Microalbuminuric patients (AER ≥ 20 μg min −1 ; n = 19), when compared with normoalbuminuric subjects, showed more elevated 24‐h BP (136/88 ± 10/10 vs. 128/83 ± 7/6 mmHg; P < 0.001 and P = 0.013, for systolic and diastolic BP respectively) and higher values of carotid‐femoral PWV (10.4 ± 2 m s −1 vs. 9.2 ± 1.3; P = 0.006). This latter difference remained statistically significant, even after correction by ancova for 24‐h systolic and diastolic BP, and body mass index (BMI, P = 0.016). Univariate regression analysis disclosed a tight correlation between AER and carotid‐femoral PWV ( r = 0.42; P = 0.0003). This association was confirmed in a multiple regression model (β = 0.35; P = 0.009) in which, as independent variables, besides PWV, 24‐h BP, age, serum glucose values, smoking status, gender and BMI, were added. Conclusions. Our results seem to confirm that microalbuminuria may represent the early renal manifestation of a widespread vascular dysfunction, and therefore it is an integrated marker of cardiovascular risk.