Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to evaluate the influence of blood pressure variability and circadian rhythm on left ventricular mass and urinary albumin excretion rate (UAE) in patients with essential hypertension. 82 untreated patients (35 women and 47 men; mean age 41.1 +/- 13.7) were recruited to this study. Mean office blood pressure at entry was 152/97 mmHg. Ambulatory blood pressure monitoring (ABPM) was performed using an Medilog ABP recorder (Oxford). Blood pressure variability was estimated as the standard deviation (SD) of systolic and diastolic ambulatory blood pressure. Urinary albumin excretion (UAE) was estimated by the radioimmunoassay during two separate days. Echocardiography was used to measure left ventricular mass and left ventricular mass index (LVMI). The median urinary albumin excretion for the whole group was 8.2 mg/day; in 18 patients (21.9%) microalbuminuria was present. Left ventricular mass index in a whole group was 109.1 g/m2; in 23 subjects (28.0%) left ventricular hypertrophy (LVH) was found. Patients with microalbuminuria as well as with left ventricular hypertrophy had higher office and 24 hour ambulatory systolic and diastolic blood pressure and higher systolic blood pressure variability. During ABPM 18 patients with absent nocturnal fall in blood pressure (non-dippers) were found; they did not display more frequent prevalence of target organ damage. Increased 24-hour blood pressure variability present in hypertensive subjects with both microalbuminuria and left ventricular hypertrophy may suggest that this phenomenon plays role in development of target organ damage.
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PMID:[Circadian rhythm and variability of blood pressure and target organ damage in essential hypertension]. 1241 6

Isolated ambulatory hypertension is a condition characterized by elevated ambulatory but normal clinic blood pressure (BP), and has been reported to be associated with increased cardiovascular risk in untreated subjects. However, little is known about the relationship between this condition and intermediate end points such as target organ damage (TOD) in treated hypertensives. We investigated the impact of isolated ambulatory hypertension on left ventricular hypertrophy (LVH) and microalbuminuria (MA) in a selected sample of treated nondiabetic hypertensives with effective and prolonged clinic BP control (BP<140/90 mmHg). Clinic BP measurements, routine diagnostic procedures, echocardiography and 24-h urine collection for MA, were undertaken in 80 patients (mean age 53+/-8 years) with essential hypertension attending our hospital outpatient centre at baseline and after an average follow-up of 30 months. At follow-up evaluation BP status was assessed by self-measurement of BP and ambulatory BP monitoring (ABPM). At the follow-up visit, 51 out of 80 patients (63.7%) reached a BP control according to ABP (average daytime BP<132/85 mmHg) criteria (group I) whereas the remaining 29 did not (group II); home BP was controlled (BP<135/85 mmHg) in all members of group I and in 86% of group II. In the overall study population, mean Sokolow voltage, LV mass index (LVMI) and urinary albumin excretion (UAE) decreased compared to baseline from 24.1+/-5.0 to 18.9+/-5.1 mm (P<0.05), 115.6+/-24.1 to 97.7+/-21.6 g/m(2) (P<0.01), 11.8+/-23.7 to 5.8+/-14.9 mg/24 h (P<0.05), respectively. The prevalence of ECG LVH, altered LV patterns and MA fell from 7.5 to 2.5% (P=NS), from 45 to 25 (P<0.01) and from 13.7 to 5.1% (P<0.05), respectively. However, when data were analysed separately for the two groups a significant decrease of echo LVH and MA was found only in patients with controlled ABP. LVMI and MA decreased from 117.1+/-23.1 to 95.9+/-22.1 g/m(2) (P<0.01) and 12.8+/-24.7 to 4.1+/-5.7 mg/24 h (P<0.05) in group I, and from 114.1+/-24.8 to 102.3+/-20.3 (P=NS) and 11.9+/-22.1 to 6.3+/-18.1 mg/24 h (P=NS) in group II. In conclusion, in the present study isolated ambulatory hypertension in treated patients is associated with a lack of regression in cardiac and extracardiac TOD, suggesting that a tight BP control throughout the 24 h plays a key role in lowering hypertension-induced structural and functional alterations at cardiac and renal level.
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PMID:Isolated ambulatory hypertension and changes in target organ damage in treated hypertensive patients. 1574 31

The aim of the research was to evaluate some clinical and hemodynamic characteristics in patients with diabetes mellitus type 1 and type 2 (DM type 1 and DM type 2), to diagnose diabetic retinopathy (DR) on early stage of its development for the correction of the disease by treating with angiotensin II type 1 receptor blocker (AT I)--Candesartan. Totally 250 patients (pts) with DM type 1 and DM type 2 were studied; they were divided into 3 groups (Gr.): Gr.1 (n=115)--pts with DM and without DR; Gr. 2 (n=43)--pts with DM type 1 and DR; Gr.3 (n=92)--pts with DM type 2 and DR. A comprehensive physical examination was conducted to obtain baseline information about the patient: clinical status, lipid profile, microalbuminuria and urine creatinine, as well as glycemia levels. Patients were treated with Candesartan (16 or 32 mg) or placebo. When necessary, other antihypertensive agents (except ACE-inhibitors) were initiated. Eye fundus monitoring was performed with evaluation of 7,300 standard zone stereoscopic pictures of the retina according to ETDRS (Early Treatment of Diabetic Retinopathy Study). The results of three year observation revealed no pathologic changes on the retina in normotensive and normoglycemic pts; pts with mild diabetic retinopathy at baseline demonstrated normal levels of ABP and blood glucose which resulted in the regression of the changes. The changes of various severity demonstrated no positive shifts in 96% of cases; DR deterioration (proliferative DR, neovascularisation stage) was observed in 4% of cases. Results of the study showed that Candesartan treatment of pts with DM resulted in positive shifts in the pathologic changes, registered on the retina and decrease in urine albumin excretion rate. Thus, we recommend to include Candesartan in the standard treatment, as the have positive effect on the course microvascular complications of diabetes mellitus both in males and females.
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PMID:[Positive effects of angiotensin [corrected] receptor blockers on the course of microvascular complications of diabetes mellitus]. 1883 32