title: Microalbuminuria in untreated prehypertension and hypertension without diabetes.
abstract: OBJECTIVE
  Hypertension (HT) and prehypertension (preHT) were independent predictors of cardiovascular diseases. Urinary albumin leakage is a manifestation of generalized vascular damage. B-type natriuretic peptide (BNP) is a vasoactive peptide secreted by left ventricle in response to myocytic stretch. We aimed to investigate relationship between microalbuminuria (MA) and BNP in untreated elevated blood pressures.
  
  
  METHODS
  Of 105 untreated prehypertensive subjects (53 men, 52 women), 100 hypertensive subjects (51 men, 49 women) and 57 normotensive subjects (32 men, 25 women) none had history of diabetes. Urine albumin excretion was measured by immunoradiometric assay in morning urine sample.
  
  
  RESULTS
  The prevalence of MA was higher in hypertensive group than in prehypertensive group and in normotensive group (Hypertensive group; 33.9%, prehypertensive; 25.9%, normotensive; 10%). Subjects with HT had higher prevalence of microalbminuria; larger body mass index, higher levels of triglycerides, blood glucose and creatinin were more common in subjects with HT than in those with preHT. In hypertensive group; patients with microalbuminuria had higher systolic blood pressure (SBP), BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (β: 0.361; P < 0.001), LVMII (β: 0.267; P = 0.011) and BNP (β: 0.284; P = 0.005) were independent variables associated with MA in hypertensives. In prehypertensive group; patients with microalbuminuria had higher SBP, BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (β: 0.264; P = 0.002), LVMI (β: 0.293; P = 0.001) and BNP (β: 0.168; P = 0.045) were associated with MA in prehypertensives.
  
  
  CONCLUSIONS
  In preHT and HT, SBP, BNP and LVMI are associated with MA. In the evaluation of increased blood pressures, in case of increased BNP and LVMI, MA should be investigated even in prehypertensive stages. The subjects with increased blood pressures should get medical treatment to prevent the effects on vascular structure and myocardium even in prehypertensive phase.
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioglu
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Osman Can
authors.initials: OC
authors.lastname: Yontar
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Karaagac
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Fahriye Vatansever
authors.initials: FV
authors.lastname: Agca
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tutuncu
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kuzeytemiz
authors.affiliation: Çanakkale Onsekiz Mart University, Cardiology Çanakkale, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Bekler
authors.affiliation: Bursa Yuksek Ihtisas Education and Research Hospital, Cardiology Bursa, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Senturk
authors.affiliation: Bursa Yuksek Ihtisas Education and Resarch Hospital, Cardiovascular Surgery Bursa, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Aydin
authors.affiliation: Adana State Hospital, Cardiology Adana, Turkey.
authors.forename: Serafettin
authors.initials: S
authors.lastname: Demir
keywords: Microalbuminuria; brain natriuretic peptide; hypertension; left ventricular mass; prehypertension