title: Microalbuminuria in primary hypertension: a guide to optimal patient management?
abstract: Accurate assessment of the global risk profile is considered a prerequisite for the optimal management of hypertensive patients. In particular, the evaluation of subclinical organ damage, namely left ventricular hypertrophy, peripheral atherosclerosis and renal function, plays a key role in optimizing therapeutic targets and strategy in individual patients. Urine albumin excretion is a low-cost, easy-to-use test and a powerful predictor of cardiovascular diseases. The search for albuminuria has, therefore, become routine in the evaluation of hypertensive patients. Moreover, albuminuria has been shown to be associated with early signs of extra-renal organ damage such as left ventricular hypertrophy, and carotid atherosclerosis. Under effective antihypertensive treatment, changes in subclinical organ damage over time, especially regression of left ventricular hypertrophy, are paralleled by modification of risk status and may serve as intermediate endpoints for treatment. More recently, changes in albuminuria have also been proposed to reflect changes in the risk of cardiovascular events. If this is confirmed by large well-designed studies, microalbuminuria may not simply be regarded as a risk predictor but become itself an independent target for treatment.
authors.affiliation: Università degli Studi di Genova and IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.affiliation: Università degli Studi di Genova and IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cappadona
authors.affiliation: Università degli Studi di Genova and IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, Genoa, Italy. roberto.pontremoli@unige.it.
authors.forename: Roberto
authors.identifier: http://orcid.org/0000-0003-1238-872X
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000419:Albuminuria / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D015995:Prevalence; D012074:Remission Induction; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Albuminuria; Cardiovascular risk; Hypertension; Organ damage; Risk factor