title: Association between urinary albumin excretion and both central and peripheral blood pressure in subjects with insulin resistance.
abstract: BACKGROUND
  Central blood pressure (cBP) predicts cardiovascular events. Regarding subclinical organ damage, the relationship between urinary albumin excretion (UAE) and cBP is rather unknown.
  
  
  OBJECTIVE
  We aimed to determine whether cBP is related to UAE, and if this relationship is stronger than that observed with peripheral blood pressure (pBP).
  
  
  METHODS
  Three hundred and twenty-four hypertensives (61% men, aged 65 ± 10 years) with insulin-resistance (77% diabetics; 23% nondiabetics with metabolic syndrome) were studied. Office pBP and cBP (radial applanation tonometry) were determined. UAE (albumin/creatinine) was averaged from three first-morning-void urine samples. Differences between patients with/without microalbuminuria, and the relationship between UAE and both pBP and cBP were analyzed. The strength of such relationship (cBP vs. pBP) was compared using a noninferiority test.
  
  
  RESULTS
  Microalbuminuria was detected in 25% of all patients. After age-adjustment and sex-adjustment, both central and peripheral SBP and pulse pressure (PP) (mmHg) were higher in microalbuminurics than in normoalbuminurics [central SBP (cSBP): 130 ± 20 vs. 124 ± 19; peripheral (pSBP): 147 ± 22 vs. 139 ± 20; central pulse pressure (cPP): 52 ± 15 vs. 47 ± 14; peripheral pulse pressure (pPP): 67 ± 16 vs. 62 ± 16, P < 0.05 for all]. Partial correlation coefficients (age-adjusted and sex-adjusted) between blood pressure (BP) and UAE were 0.175 for cSBP, 0.143 for pSBP, 0.124 for cPP (P < 0.05 for all), and 0.092 for pPP (P = 0.117). Neither cBP nor pBP were superior to each other in their association with UAE or with microalbuminuria. Comparisons between cBP and pBP by means of noninferiority tests revealed no differences in the magnitude of correlation coefficients (P = 0.265 for SBP; P = 0.212 for PP), or differences in means between patients with/without microalbuminuria (P = 0.327 for SBP; P = 0.054 for PP).
  
  
  CONCLUSIONS
  Although cBP is related with UAE, this relationship is not superior to that of office peripheral BP.
authors.affiliation: Hypertension Unit, Nephrology Department, Hospital Universitari del Mar, Barcelona, Spain. aoliveras@hospitaldelmar.cat
authors.forename: Anna
authors.initials: A
authors.lastname: Oliveras
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ortiz
authors.forename: Julián
authors.initials: J
authors.lastname: Segura
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Nieves
authors.initials: N
authors.lastname: Martell-Claros
authors.forename: Luis
authors.initials: L
authors.lastname: Vigil
authors.forename: Carmen
authors.initials: C
authors.lastname: Suarez
authors.forename: Manuel Á
authors.initials: MÁ
authors.lastname: Gomez-Marcos
authors.forename: María
authors.initials: M
authors.lastname: Abad-Cardiel
authors.forename: Susana
authors.initials: S
authors.lastname: Vazquez
authors.forename: Juan J
authors.initials: JJ
authors.lastname: de la Cruz
authors.forename: Stanley S
authors.initials: SS
authors.lastname: Franklin
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Alejandro
authors.initials: A
authors.lastname: de la Sierra
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D008875:Middle Aged