title: Left ventricular mass index as a predictor of new-onset microalbuminuria in hypertensive subjects: a prospective study.
abstract: BACKGROUND
  We aimed to investigate the predictive role of left ventricular mass and its reduction on the development of new-onset microalbuminuria (MA) in newly diagnosed hypertensive patients.
  
  
  METHODS
  A total of 207 nondiabetic, normoalbuminuric patients without clinical organ damage (aged 50.8 ± 10.1 years, 132 male, 84 smokers) with baseline office blood pressure (BP) 148/96 mm Hg were followed for a mean period of 3.3 ± 1.3 years. At baseline and last follow-up visit, all patients underwent office and 24-h ambulatory BP monitoring, albumin to creatinine ratio (ACR) determination, and echocardiographic assessment of left ventricular mass index (LVMI). All patients were treated with antihypertensive therapy during the follow-up period. We defined MA as ACR between 20 and 300 mg/g for men and 30-300 mg/g for women, effective BP control as office BP <140/90 mm Hg in ≥75% of total number of visits, and LVMI reduction as the decline of LVMI at end-follow-up of ≥15% with respect to the baseline value.
  
  
  RESULTS
  Between baseline and last follow-up visit, LVMI decreased by 6.84 ± 21.5 g/m(2) (P < 0.01); 64.3% (n = 133) of participants achieved BP control during the follow-up period. Of the total population, 5.8% (n = 12) developed MA during follow-up. Cox-regression analysis, after adjustment for clinical variables, revealed that increase of LVMI by 1 s.d. (23.3 g/m(2)) conferred a 15% increased risk of new-onset MA, while LVMI reduction and BP control were both associated with almost 100% reduced risk of MA development.
  
  
  CONCLUSIONS
  LVMI and its reduction were qualified as predictors of new-onset MA in newly diagnosed hypertensive patients, beyond BP control.
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Andrikou
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Costas
authors.initials: C
authors.lastname: Thomopoulos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Andrikou
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kasiakogias
authors.forename: Ioannis
authors.initials: I
authors.lastname: Leontsinis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kordalis
authors.forename: Themis
authors.initials: T
authors.lastname: Katsimichas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000419:Albuminuria / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000000981:diagnostic imaging; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies