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Microalbuminuria, renal function and development of sustained hypertension: a longitudinal study in the early stage of hypertension.

Abstract：

OBJECTIVE:Microalbuminuria (MA) is a marker of adverse outcome in hypertension. The aim of this study was to investigate the association of MA with cardiovascular risk factors and glomerular hyperfiltration in the early stage of hypertension and to assess its predictive value for the development of sustained hypertension requiring antihypertensive treatment. DESIGN AND PARTICIPANTS:We studied 1041 young stage 1 hypertensive subjects. Study variables were 24-h ambulatory blood pressure and heart rate, anthropometric measures, metabolic variables, creatinine clearance and lifestyle factors analyzed as a function of ascending urinary albumin measured from 24-h collections. Subjects were followed until they developed sustained hypertension and were eligible for antihypertensive medication according to current guidelines. SETTING:Seventeen outpatient clinics in Italy. RESULTS:Eighty-five percent of the subjects were normoalbuminuric, 9% had borderline MA, and 6% had overt MA. No between-group differences were found for age, body mass index, heart rate, lifestyle factors and biochemistry in both genders. Creatinine clearance was greater in the subjects with overt MA and borderline MA than in the normoalbuminuric subjects (P = 0.003 and 0.011, respectively). In a two-way ANCOVA, microalbuminuric subjects both with hyperfiltration (P < 0.001) and with normal filtration (P = 0.04) had higher 24-h systolic blood pressure than subjects with normoalbuminuria and normal filtration. In a Cox analysis, neither MA nor hyperfiltration were significant predictors of development of sustained hypertension. CONCLUSION:MA is not associated with an adverse metabolic risk profile in the early stage of hypertension. MA is associated with greater hemodynamic load and with glomerular hyperfiltration in this clinical setting, but does not help in predicting those subjects destined to develop sustained hypertension requiring antihypertensive therapy.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Palatini P,Mormino P,Mos L,Mazzer A,Dorigatti F,Zanata G,Longo D,Garbelotto R,De Toni R,Graniero G,Pessina AC,HARVEST Study Group.

doi

10.1097/00004872-200501000-00028

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

175-82

issue

eissn

0263-6352

issn

1473-5598

pii

00004872-200501000-00028

journal_volume

pub_type

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Microalbuminuria, renal function and development of sustained hypertension: a longitudinal study in the early stage of hypertension.