title: Microalbuminuria in essential hypertension.
abstract: Some patients with essential hypertension manifest increased urinary albumin excretion (UAE). Hypertensive patients with microalbuminuria manifest abnormal circadian variation of blood pressure, increased serum levels of LDL-cholesterol and lipoprotein(a), a greater rise of serum insulin in response to an oral glucose tolerance test, and greater thickness of the carotid artery than patients without microalbuminuria. A 7 year follow-up of 141 hypertensive patients, 54 with microalbuminuria and 87 without microalbuminuria, we observed 12 cardiovascular events in patients with microalbuminuria and only 2 events in the patients with normal urine albumin excretion (P < 0.0002). Creatinine clearance decreased more in patients with microalbuminuria than in those with normal UAE. In conclusion, hypertensive individuals with microalbuminuria manifest a greater incidence of cardiovascular events and more decline in renal function than patients with normal UAE. We propose that measurements of UAE may be a useful marker for cardiovascular risk in patients with essential hypertension.
authors.affiliation: UO of Nephrology, Spedali Riuniti, Livorno, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: R
authors.initials: R
authors.lastname: Bigazzi
authors.forename: V M
authors.initials: VM
authors.lastname: Campese
mesh_terms: D000419:Albuminuria / Q000150:complications* / Q000473:pathology; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure; D016893:Carotid Stenosis / Q000473:pathology; D002940:Circadian Rhythm; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000652:urine*; D007333:Insulin Resistance; D008074:Lipoproteins / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D008074:Lipoproteins; D003404:Creatinine