Microalbuminuria in treated hypertensives: only a mirror image of cardiovascular risk? The HUNT Study, Norway.
OBJECTIVE
Microalbuminuria as an independent marker of cardiovascular morbidity and mortality in hypertensive individuals is under debate. The aim of this study was to study the possible associations between microalbuminuria on one hand and known cardiovascular risk factors and cardiovascular disease on the other hand, in a large, unselected population of treated hypertensives without diabetes.


METHODS
Cross-sectional study.


METHODS
Participants of the HUNT Study, Norway (n = 65,258).


METHODS
5,369 individuals (> or =20 years) with treated hypertension delivered three morning urine samples for microalbuminuria analysis.


METHODS
Microalbuminuria expressed as albumin-to-creatinine ratio, cardiovascular risk factors and cardiovascular disease.


RESULTS
Increasing age, pulse pressure (systolic blood pressure-diastolic blood pressure), s-creatinine, cigarette pack years, cardiovascular disease, antihypertensive medication group, and years with antihypertensive medication were significantly associated with microalbuminuria in men. Increasing pulse pressure, cigarette pack years, and antihypertensive medication group were associated with microalbuminuria in women, adjusted for other cardiovascular risk factors. When excluding individuals of both sexes with self-reported cardiovascular disease and blood pressure > 160/90 mm Hg, no variable associated with cardiovascular risk factors registered was statistically associated with microalbuminuria.


CONCLUSIONS
The present study indicates that microalbuminuria mainly represents a mirror image of hypertension (BP > 160/90) and prior or present cardiovascular disease. We therefore question whether the treatment quality would improve if yet another risk factor, microalbuminuria, were introduced as a routine test in treated hypertensives.
Kvenild
Kurt
K
HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Verdal, Norway. kurt.kvenild@ntnu.no
Romundstad
Solfrid
S
Midthjell
Kristian
K
Krüger
Oystein
O
Hallan
Hans
H
Holmen
Jostein
J
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D000959:Antihypertensive Agents; D003404:Creatinine