title: Residual small artery impairment in hypertensive patients with normal albumin-creatinine ratio.
abstract: Objectives Previous studies have suggested that urine albumin excretion (UAE) mirrors generalized vascular damage; however, it is unclear to which degree UAE mirrors small artery impairment. Design We enrolled 67 patients with uncomplicated essential hypertension (EH) during stable antihypertensive therapy. F-Rmin, ACR on three non-consecutive morning urine samples, pulse wave velocity (PWV), and 24-h ambulatory blood pressure (ABPM) were measured. Results ACR was low (0.39 and 0.30-0.60), but abnormal small artery structure defined as F-Rmin > mean + 2 standard deviations of normotensive value (1.99 + 1 mmHg min/(ml/100 ml)) was present in 45% (n = 30). The mean F-Rmin was 2.89 ± 0.09 mmHg min/(ml/100 ml). ACR correlated significantly to PWV (r(2 )=( )0.11; p < 0.05) and pulse pressure (r(2 )=( )0.15; p < 0.001), but not F-Rmin and (r(2 )=( )0.05, p = 0.07). Conclusions Abnormal microvascular structure was present even in EH patients with low UAE. ACR correlated to arterial stiffness and not to small artery structure; therefore, UEA did not reflect microvascular damage in this population. ACR and F-Rmin thus reflect two distinct types of subclinical organ damage in hypertension.
authors: a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.
authors: Ashkan
authors: A
authors: Eftekhari
authors: a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.
authors: Signe Nielsen
authors: SN
authors: Wiggers
authors: a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.
authors: Ole Norling
authors: ON
authors: Mathiassen
authors: a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.
authors: Kent Lodberg
authors: KL
authors: Christensen
mesh_terms: D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D003404:Creatinine / Q000032:analysis*; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods; D065667:Renal Elimination; D015203:Reproducibility of Results; D013223:Statistics as Topic; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine
keywords: Essential hypertension; forearm minimum vascular resistance; pulse wave velocity; urine albumin excretion