Relationship between albumin excretion rate, ambulatory blood pressure and left ventricular hypertrophy in mild hypertension

Objective: To study the relationship of urinary albumin excretion to ambulatory blood pressure and other cardiovascular risk factors in borderline to mild hypertension. Patients and methods: We studied 779 patients with borderline to mild hypertension (mean+/-SEM age 33+/-0.3 years; mean+/-SEM office blood pressure 146+/-0.4/94+/-0.2 mmHg) at 17 hypertension clinics in northeast Italy. Office and 24-h blood pressures were recorded with simultaneous urine collection for albumin measurement. In 510 subjects, left ventricular mass was measured by echocardiography. Results: Subjects with overt (greater than or equal to 30mg/24 h) and borderline (16-29 mg/24 h) microalbuminuria had similar 24-h blood pressure levels, higher than those in the subjects without microalbuminuria. In the univariate and multiple regression analyses the albumin excretion rate was closely correlated with 24-h systolic blood pressure and not related to age, body mass index, metabolic parameters, lifestyle factors and degree of left ventricular hypertrophy. Conclusions: Borderline values of urinary albumin excretion (16-29 mg/24 h) may be clinically relevant in subjects with borderline to mild hypertension. Renal and cardiac damage do not develop in parallel in the initial phases of hypertension.