title: Association between undiagnosed hypertension and microalbuminuria in South Asians without known diabetes.
abstract: Data suggest increased rates of chronic kidney disease (CKD) in those with undiagnosed hypertension (HTN). Our study aimed to determine the prevalence of CKD in undiagnosed hypertensives in a previously unreported subgroup of individuals of South Asian ethnicity. We analysed data from subjects in the ADDITION-Leicester study, a UK based multiethnic, community diabetes screening study. Standard definitions included: HTN-mean recorded BP of ⩾140/90 mm Hg, CKD stage 3 and above-estimated glomerular filtration rate (eGFR) <60 ml min(-1) per 1.73 m2 and microalbuminuria as albumin creatinine ratio ⩾3 mg mmol(-1). Logistic regression was performed with age, gender and body mass index (kg m(-2)) as co-variates. 6082 individuals (52.5% female, mean age, 57.2 years; White European, 77.8% and South Asian, 22.0%), 31.1% had undiagnosed HTN. Overall, individuals with undiagnosed HTN compared with normotensives had an odds ratio for microalbuminuria of 2.24 (95% confidence interval (CI): 1.72-2.94). For South Asians, the odds ratio was 3.81. (95% CI: 2.24-6.47) for microalbuminuria with a trend towards an eGFR<60 ml min(-1) per 1.73 m2. Future studies should consider intensified screening for HTN to refine the population suitable for CKD screening, particularly in the South Asian ethnic group.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, UK.
authors.forename: R W
authors.initials: RW
authors.lastname: Major
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Department of Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK.
authors.forename: W
authors.initials: W
authors.lastname: Crasto
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, UK.
authors.forename: L J
authors.initials: LJ
authors.lastname: Gray
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Webb
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, UK.
authors.forename: K
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology*; D001211:Asia, Western / Q000208:ethnology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology*