Microalbuminuria in treated hypertensive men at high risk of coronary disease. The Risk Factor Intervention Study Group.
OBJECTIVE
To examine whether microalbuminuria is a marker of cardiovascular disease in treated hypertensive men without diabetes mellitus at high coronary risk and to examine the associations between microalbuminuria and recognized cardiovascular risk factors.


METHODS
Cross-sectional study.


METHODS
Outpatient clinic in city hospital.


METHODS
Three hundred and thirty-three treated hypertensive men, aged 50-72 years, either with a serum cholesterol of > or = 6.5 mmol/l or smokers, or both. The patients were recruited mainly from a population-based sample of hypertensive men. Patients with diabetes mellitus or overnight urinary albumin excretion of > 100 mg/12 h were excluded from the analyses.


METHODS
Overnight urinary albumin excretion, prevalence of microalbuminuria (defined as 17-100 mg/12 h) and organ damage (cardiovascular events or major electrocardiogram changes, or both), various well-established risk factor levels, blood glucose and plasma insulin responses to an oral glucose tolerance test.


RESULTS
Microalbuminuria was found in 25% of the cohort. Among microalbuminuric patients, organ damage was significantly more common (47.6%) than in the normoalbuminuric group (30.9%). However, the sensitivity and specificity of microalbuminuria as a marker of organ damage were only 34 and 80%, respectively. Microalbuminuria was significantly related to body mass index and waist:hip ratio, age and plasma insulin during oral glucose tolerance testing. These relationships also persisted after adjustment for treatment with thiazides or beta-blockers.


CONCLUSIONS
In treated hypertensive men without diabetes mellitus, microalbuminuria was associated with factors known to be related to insulin resistance. It had a low sensitivity as a marker of concomitant cardiovascular disease.
Department of Medicine, Sahlgren's Hospital, University of Gothenburg, Sweden.
S
S
Agewall
B
B
Persson
O
O
Samuelsson
S
S
Ljungman
H
H
Herlitz
B
B
Fagerberg
D000368:Aged; D000419:Albuminuria / Q000150:complications* / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology / Q000652:urine*; D003430:Cross-Sectional Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000652:urine*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
D000959:Antihypertensive Agents; D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin