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RESEARCH PRODUCT

Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients

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. Objectives.  To evaluate, in a group of nondiabetic essential hypertensive patients with normal renal function, the relationship between albumin excretion rate (AER) and carotid-femoral pulse wave velocity (PWV), as an index of aortic stiffness. Design.  Cross-sectional study. Setting.  Outpatient hypertension clinic. Subjects.  Seventy patients with mild-to-moderate essential hypertension, aged 42 ± 8 years, never pharmacologically treated. All subjects underwent routine laboratory tests, 24-h ambulatory blood pressure (BP) monitoring, measurement of carotid-femoral PWV, by means of a computerized method, and AER. Results.  Microalbuminuric patients (AER ≥ 20 μg min−1; n = 19), when compared with normoalbuminuric subjects, showed more elevated 24-h BP (136/88 ± 10/10 vs. 128/83 ± 7/6 mmHg; P < 0.001 and P = 0.013, for systolic and diastolic BP respectively) and higher values of carotid-femoral PWV (10.4 ± 2 m s−1 vs. 9.2 ± 1.3; P = 0.006). This latter difference remained statistically significant, even after correction by ancova for 24-h systolic and diastolic BP, and body mass index (BMI, P = 0.016). Univariate regression analysis disclosed a tight correlation between AER and carotid-femoral PWV (r = 0.42; P = 0.0003). This association was confirmed in a multiple regression model (β = 0.35; P = 0.009) in which, as independent variables, besides PWV, 24-h BP, age, serum glucose values, smoking status, gender and BMI, were added. Conclusions.  Our results seem to confirm that microalbuminuria may represent the early renal manifestation of a widespread vascular dysfunction, and therefore it is an integrated marker of cardiovascular risk.