Evaluation of subclinical organ damage for risk assessment and treatment in the hypertensive patient: role of microalbuminuria.
Microalbuminuria, i.e., abnormal urinary excretion of albumin, which is detectable by low cost and widely available tests, is a first-line tool for identifying hypertensive patients who are at higher cardiovascular (CV) risk. Numerous studies have provided evidence that microalbuminuria is a concomitant of cardiac and vascular damage as well as a strong, independent predictor of CV events. An important, emerging issue is that the risk for CV morbidity and mortality is linearly related to urinary albumin excretion and persists well below the currently used cutoff for defining microalbuminuria. Furthermore, late-breaking evidence suggests that a reduction of albuminuria under antihypertensive treatment is paralleled by changes in CV risk. The routine search for target organ damage by means of microalbuminuria could lead to a significant improvement in the evaluation and treatment of patients with primary hypertension.
Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy. roberto.pontremoli@unige.it
Roberto
R
Pontremoli
Giovanna
G
Leoncini
Francesca
F
Viazzi
Elena
E
Ratto
Valentina
V
Vaccaro
Valeria
V
Falqui
Angelica
A
Parodi
Novella
N
Conti
Cinzia
C
Tomolillo
Giacomo
G
Deferrari
D000418:Albumins / Q000378:metabolism; D000419:Albuminuria / Q000175:diagnosis* / Q000473:pathology; D000959:Antihypertensive Agents / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000628:therapy*; D002319:Cardiovascular System / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000378:metabolism
D000418:Albumins; D000959:Antihypertensive Agents