title: Parallel deterioration of albuminuria, arterial stiffness and left ventricular mass in essential hypertension: integrating target organ damage.
abstract: BACKGROUND
  Albuminuria, arterial stiffening and left ventricular hypertrophy (LVH) constitute target organ damage. We estimated whether increased urinary albumin excretion, assessed by albumin-to-creatine ratio (ACR), and carotid to femoral pulse wave velocity (c-f PWV) were accompanied by augmented left ventricular (LV) mass index (LVMI) in hypertension.
  
  
  METHODS
  In 428 non-diabetic untreated hypertensives (257 men, mean age = 52 years, office blood pressure (BP) = 146/93 mm Hg) the distributions of ACR and c-f PWV were split by the median (8 mg/g and 7.8 m/s, respectively).
  
  
  RESULTS
  Age, male sex, 24 h systolic BP, ACR and c-f PWV were the independent predictors of LVMI (R(2) = 0.478, p < 0.0001). Among patients with low ACR (n = 198), those with high c-f PWV (n = 84) compared to those with low c-f PWV (n = 114) were characterized by increased LVMI (by 8.9 g/m(2), p = 0.012) and prevalence of LVH (30 vs. 14%, p = 0.015). Similarly among patients with high ACR (n = 230), those with high c-f PWV (n = 123) compared to those with low c-f PWV (n = 107) exhibited heightened LVMI (by 13.6 g/m(2), p = 0.001).
  
  
  CONCLUSIONS
  Increased ACR in conjunction with pronounced arterial stiffness is accompanied by augmented LV mass and higher LVH rates. Furthermore, the interrelationships between albuminuria, c-f PWV and LVMI suggest parallel target organ damage progression.
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Andrikou
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Dimitriadis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Flessas
authors.forename: Vagelis
authors.initials: V
authors.lastname: Chatzistamatiou
authors.forename: Charalampos
authors.initials: C
authors.lastname: Grassos
authors.forename: Maria
authors.initials: M
authors.lastname: Papavasiliou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Papadopoulos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness / Q000502:physiology*