Prevalence of microalbuminuria in non-diabetic hypertensive patients attended by Portuguese GPs.
OBJECTIVE
To determine the prevalence of microalbuminuria in a sample of non-diabetic hypertensive patients and to correlate the presence of microalbuminuria with the patients' different clinical profiles.


METHODS
A descriptive, observational, cross-sectional and non-interventional enquiry based on strict respect for the standard general practitioner's medical practice and the physician-patient relationship.


METHODS
Portuguese general practitioners (GPs) who had participated in a preliminary opinion survey on evaluation of renal function in hypertensive patients.


METHODS
Non-diabetic uncontrolled and controlled hypertensive patients.


METHODS
Data were collected via written questionnaires completed by physicians at inclusion. Standard biochemical and microalbuminuria tests were performed by the laboratory chosen by each physician following the laboratory's usual practice. A Micral-Test"* to detect microalbuminuria was also performed on a spot morning urine collection.


RESULTS
Between May and October 2003, 531 general practitioners recruited 1582 non-diabetic hypertensive patients (58% female) with a mean age of 60.4 +/- 11.3 years; 11% of them were physically active and 10% were smokers. Almost all the patients (>95%) were under antihypertensive medication; 44% were also taking statins and 19% aspirin. Of the 1582 subjects, 57% (n=906) and 41% (n=652) had uncontrolled and controlled hypertension respectively, and 34% (n=539) had markers of renal function damage such as proteinuria, hematuria, microalbuminuria or albuminuria. Data for the Micral-Test were obtained in 98% of the patients and 29% (n=458) had a positive test. The mean albuminuria level was 12.34 +/- 37.88 mg/l. Seventy-six per cent of the patients (n=1196) had a normal urine test. Microalbuminuria was significantly more frequent in patients with uncontrolled (29%) than in controlled (20%) hypertension (p < 0.01), with left ventricular hypertrophy (LVH) (33%) than without (24%) (p < 0.01), with ventricular arrhythmias (35%) than without (25%) (p < 0.05) and with cerebral hemorrhage or transient ischemic attack (41%) than without (25%) (p < 0.001).


CONCLUSIONS
This study confirmed that microalbuminuria is a powerful discriminator of high cardiovascular risk, and is associated with higher BP values and higher prevalence of LVH, ventricular arrhythmias and cerebrovascular disease in non-diabetic hypertensive patients.
Polónia
Jorge
J
Portuguese Association of Hypertension, Portuguese Society of Gardiology, Lisbon, Portugal. nop25569@mail.telepac.pt
Carmona
Jose
J
Mendes
Eduardo
E
Pisco
Luís
L
D000419:Albuminuria / Q000150:complications* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence