MICROALBUMINURIA IN ESSENTIAL-HYPERTENSION

BACKGROUND: The occurrence of microalbuminuria (mAlb) in essential hypertension (HT) was evaluated. METHODS: 100 patients were studied (56 males), with mean age 39 +/- 6 years, body mass index (BMI) 28 +/- 4.32 had borderline HT, 47 had mild HT and 21 had moderate HT. 74 were in stage I of the WHO and 26 were in stage II. All had normal renal function (creatinine 91 +/- 12-mu-mol, Clcr 92 +/- 13 ml/m/1,73 m2) and no proteinuria as measured by sulphosalicylic acid. mAlb was immunonefelometrically measured in two 24-hour urine samples, and was given as urinary albumin excretion (UAE). In 62 patients, noninvasive ambulatory recording of blood pressure (NIAR) was carried out. In 39, ventricular mass was estimated by echocardiography. RESULTS: UAE was correlated with SBP24h (r = 0.39) and DBP24h, but not with SBP or DBP. UAE was greater in patients with moderate HT than in tose with mild or borderline HT (p < 0.01). UAE was < 20 mg/24 h in 70 patients (group A) and > 20 mg/24 h in 30 (group B). The comparative analysis of the two groups showed different clinical BP values (SBP p < 0.01; DBP p < 0.001) and NIAR (SBP 24 h p < 0.001; DBP 24 h p < 0.05). In the 47 patients with mild HT the only differential parameter between groups A abd B was SBP24h (p < 0.05). Regarding echocardiographic data, in higher UAE levels a greater left ventricular mass index was found in males (chi-square p < 0.05). CONCLUSIONS: Increased mAlb is associated with more severe HT. This finding may be helpful for the initial evaluation of hypertensive patients.