[Microalbuminuria--a new cardiovascular risk factor?].
Microalbuminuria is an established risk factor for renal disease, especially in the diabetic population. Recent studies have shown that microalbuminuria has also a highly relevant predictive value for cardiovascular morbidity and mortality. From normal to overt proteinuria levels, albuminuria shows a continuous marked increase in cardiovascular risk. This association is independent of other "classical" cardiovascular risk factors such as hypertension, hyperlipidemia or smoking. Furthermore it has a predictive value not only for patients with diabetic or renal disease, but also for hypertensive individuals or the general population. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to display not only reno--but also cardioprotective effects. Their unique ability to lower albuminuria by 40% is related to a significant risk reduction in cardiovascular mortality. New clinical trials are needed to define "normal" albuminuria levels and how low we should go.
Eisenberger
U
U
Klinik und Poliklinik für Nephrologie und Hypertonie, Universitätsspital, Bern. ute.eisenberger@insel.ch
Huynh-Do
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U
D000419:Albuminuria / Q000188:drug therapy* / Q000401:mortality*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate
D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents