title: Does albuminuria correlate with silent myocardial ischemia and delayed heart rate recovery in hypertensive men without diabetes mellitus.
abstract: BACKGROUND
  In diabetes patients, albuminuria has been proven to be an independent predictor for SMI and delayed heart rate recovery (HRR). However, in hypertensive patients without diabetes the correlation is still unclear.
  
  
  OBJECTIVE
  To determine the correlation between albuminuria to SMI and delayed HRR in hypertensive patients without diabetes.
  
  
  METHODS
  Fourty consecutive asymptomatic primary hypertensive men, aged 40-60 years, without diabetes were included. They underwent treadmill stress testing (TST) and collection of spot urine to measure albumin urine to creatinine ratio (ACR). SMI and HRR at first, second, and third minute were then recorded. SMI was diagnosed if positive ischemic criteria of TST was met without anginal symptom. Albuminuria and delayed HRR were diagnosed based on the treshold value respectively.
  
  
  RESULTS
  SMI was diagnosed in 15 % patients. The prevalence of delayed HRR at the first-, second-, and third-minute after exercise were 60, 80, and 52.5 % respectively. Albuminuria was significantly associated with SMI [OR 13.889 (95 % CI 1.423-135.544), p = 0.014]. ROC curve analysis demonstrated the area under the curve (AUC) = 0.784 [(95 % CI 0.588-0.98), p = 0.028], with subsequent calculated sensitivity, specificity, positive- and negative-predictive value of albuminuria to predict SMI were 83.3, 73.5, 35.7, and 96.2 % respectively. Those were no significant correlation between albuminuria and delayed HRR at first, second, and third minute.
  
  
  CONCLUSIONS
  Albuminuria is a potential marker for excluding SMI in asymptomatic hypertensive men without diabetes.
authors: Cardiology and Vascular Medicine Department, Faculty of Medicine, University of Sam Ratulangi/Cardiovascular and Brain Center, RD Kandou General Hospital, Raya Tanawangko Street, Manado, North Sulawesi, Indonesia, winata.johan@gmail.com.
authors: Johan
authors: J
authors: Winata
authors: Agnes L
authors: AL
authors: Panda
authors: R Abdul
authors: RA
authors: Azis
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D019540:Area Under Curve; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D020127:Recovery of Function; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine