THE PREVALENCE OF MICROALBUMINURIA IN DIFFERENT HYPERTENSIVE PHENOTYPES
Author Block DW Armstrong, M Nault, D Brouillard, MF Matangi, Kingston, Ontario
BACKGROUND: Microalbuminuria (30-300mg/L) on a spot sample of urine is a subclinical maker of cardiovascular risk. Microalbuminuria is also an important prognostic marker for predicting kidney disease in patients with diabetes mellitus and hypertension. The purpose of our investigation was to determine the differences in degree of microalbuminuria in patients with different hypertensive phenotypes as determined by 24hr ambulatory blood pressure monitoring (ABPM).
METHODS and RESULTS: BLOODfile and 24hrABPMfile, the biochemical and ABPM modules of CARDIOfile, our cardiology database was searched for all patients who had both an ABPM and measurement of microalbuminuria within 90 days of each other. There were 535 patients who fulfilled these criteria and were used in this analysis. One way ANOVA was used to determine differences between means and Tukey-Kramer comparisons test between groups.
Of the 535 patients, 33 were normotensive on no drugs, (NT), 23 had white coat syndrome, (WCS), 52 were newly diagnosed hypertensives, (NHT), 98 were controlled hypertensives, (CHT), 11 had masked hypertension, (MHT), 137 were controlled hypertensives with white coat effect, (WCE) and 181 were uncontrolled hypertensives on treatment, (UHT).
RESULTS: See figure.
CONCLUSION: It is clear from these data that patients with uncontrolled hypertension have significantly more microalbuminuria. In fact, generally with increasing complexity of hypertension there is increasing microalbuminuria. The masked hypertension (MHT) and controlled hypertensives with white coat effect data are interesting but did not reach statistical significance. The other interesting finding is that there is no statistical significant difference in degree of microalbuminuria in normotensive (NT), white coat syndrome (WCS), newly diagnosed hypertension (NHT) or controlled hypertensives.