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


METHODS
Cross-sectional study.


METHODS
Outpatient hypertension clinic.


METHODS
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 > or = 20 microg 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 (beta = 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.
Mulè
G
G
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Centro Ipertensione, Università di Palermo, Palermo, Italy. giusemme@email.it
Cottone
S
S
Vadalà
A
A
Volpe
V
V
Mezzatesta
G
G
Mongiovì
R
R
Piazza
G
G
Nardi
E
E
Andronico
G
G
Cerasola
G
G
D000328:Adult; D000419:Albuminuria / Q000503:physiopathology*; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004548:Elasticity; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011674:Pulse; D012044:Regression Analysis; D012307:Risk Factors