The relations of microalbuminuria to ambulatory blood pressure and myocardial wall thickness in a population.

Abstract

OBJECTIVES: To examine the relationship between microalbuminuria (20-200 microg min(-1)) and 24 h ambulatory blood pressure and heart wall thickness, in a representative population sample of men and women aged 56-65 years. DESIGN: Every second individual aged 56-65 years (n=488) in the district, was invited for a health examination, which included determination of urinary albumin and creatinine (overnight sample). The highest and lowest decentile of urinary albumin/creatinine ratio were compared. SETTING: The district of the Primary Health Care and Research Centre of Mölnlycke, Sweden. SUBJECTS: After excluding 2 individuals with a urinary albumin excretion exceeding 200 microg min(-1). 26 subjects (group 1) could be compared with 27 subjects in the lowest decentile (group 2). MAIN OUTCOME MEASURES: Comparison between the determinations of the ambulatory blood pressure and echocardiographic variables in the two groups. RESULTS: Group 1 had significantly higher 24 h ambulatory blood pressure, and heart septum and posterior wall thickness as well as significantly higher fasting blood glucose and serum triglyceride concentrations. The differences in blood pressure (P < 0.05) but not heart wall thickness remained significant (P<0.05) after excluding subjects with hypertension, angina pectoris, treated diabetes mellitus, and/or history of heart or cerebrovascular disease. When excluding individuals with both treated and untreated diabetes mellitus, fasting blood glucose concentration was higher in group 1. The waist-hip ratio, weight and body mass index did not differ between the groups. CONCLUSIONS: The findings indicate that microalbuminuria is related to signs of cardiovascular and metabolic influence and therefore could be a valuable tool for grading the risk of later cardiovascular morbidity.