Associations of microalbuminuria and blood pressure with carotid, aortic and femoral atheromatous plaques in elderly Finns.
OBJECTIVE
To evaluate the possible associations of microalbuminuria (MA) and blood pressure (BP) with the ultrasonographic manifestations of carotid, aortic and femoral atherosclerosis in 65-year-old Finns.


METHODS
Ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycemic subjects (NGT). Urinary albumin and creatinine concentrations were measured from an early morning spot urine sample, and the urinary albumin-to-creatinine ratio (ACR) of > or = 2.5 mg/mmol in men and > or = 3.5 mg/mmol in women was used as a measure of MA. Hypertension was defined as either a systolic BP of > or = 160 mmHg or a diastolic BP of > or = 95 mmHg or being on antihypertensive medication.


RESULTS
Eighteen subjects were microalbuminuric and 176 subjects normoalbuminuric. MA was associated with diabetes mellitus and high systolic and diastolic BP. The subjects were divided into two groups according to the median total number of carotid, aortic and femoral plaques: > or = 9 versus 0-8 plaques. A high number of plaques were associated with hypertension, male gender, smoking and MA. When the study subjects were stratified according to hypertension, it turned out that MA was associated with a high number of plaques in hypertensive, but not in nonhypertensive subjects. According to the results of logistic regression analysis with a high number of plaques as the dependent variable, the unadjusted OR for smoking was 6.0 (95% CI 2.4-15.3) in hypertensive subjects. Microalbuminuria was of borderline statistical significance (OR 4.5, 95% CI 0.9-22.9). After adjustment for systolic blood pressure and fasting glucose concentration, the OR for microalbuminuria was reduced to 3.3 (95% CI 0.6-18.4).
Rajala
Ulla
U
Department of Public Health Science and General Practice, University of Oulu, Aapistie 1, 90220 Oulu, Finland. ulla.rajala@oulu.fi
Laakso
Mauri
M
Päivänsalo
Markku
M
Pelkonen
Outi
O
Ruokonen
Aimo
A
Suramo
Ilkka
I
Keinänen-Kiukaanniemi
Sirkka
S
D000368:Aged; D000419:Albuminuria / Q000453:epidemiology*; D001024:Aortic Valve Stenosis; D001161:Arteriosclerosis / Q000453:epidemiology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male
D001786:Blood Glucose