title: Albumin-to-creatinine ratio predicts change in ambulatory blood pressure in normotensive persons: a 7.5-year prospective study.
abstract: BACKGROUND
  The relationship between urinary albumin excretion and blood pressure (BP) has been found to be positive in hypertensive and normotensive subjects. It is not known, in a normotensive and nondiabetic sample, whether elevated urinary albumin levels predict future increases in BP.
  
  
  METHODS
  In this prospective study, we followed a cohort of 108 individuals who were initially free of hypertension and diabetes for an average of 7.7 years. Urinary albumin excretion was determined at baseline by radioimmunoassay in a 24-h collection. Ambulatory BP monitoring was used to assess BP at baseline and at 7.5-year follow-up. Regression models were used to evaluate the relationship of baseline urinary albumin-to-creatinine ratio to baseline BP and average rate of change in BP before and after controlling for several potential confounding variables.
  
  
  RESULTS
  Baseline albumin-to-creatinine ratio was not associated with baseline ambulatory BP, but was positively associated with change in ambulatory BP. Before and after controlling for sex, race/ethnicity, age, body mass index at baseline, and change in body mass index, urinary albumin-to-creatinine ratio was found to be a significant independent predictor of change in awake and sleep systolic and diastolic BPs (all P < .05). It also independently predicted hypertension status at follow-up.
  
  
  CONCLUSIONS
  In healthy normotensive individuals, the urinary albumin-to-creatinine ratio predicts change in ambulatory BPs 7.5 years later. This finding suggests that urinary albumin excretion may be an important marker for processes that increase BP over time.
authors.affiliation: Department of Public Health, Weill Medical College of Cornell University, New York, New York 10021, USA. lig2002@med.cornell.edu
authors.forename: Linda M
authors.initials: LM
authors.lastname: Gerber
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Pickering
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism*; D000419:Albuminuria / Q000652:urine; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D003404:Creatinine / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000418:Albumins; D015415:Biomarkers; D003404:Creatinine