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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of the present study was to assess factors related to the presence of microalbuminuria in essential hypertension. Ninety-five patients with essential hypertension (58 males and 37 females, mean age 38.6 +/- 6.1 years) who had never been treated previously for hypertension were included in the study. Patients with nephropathy or diabetes mellitus, hyperglycemia > 120 mg/dL, glomerular filtration rate < 80 mL/min/1.73 m2, urinary tract infection, or positive dipstick for albumin or glucose were excluded. Blood pressure, echocardiographically determined left ventricular mass, serum biochemistry, and lipid profile were obtained. Twenty-four-hour urinary albumin excretion (UAE) was measured on two separate days using an immunonephelometric assay. Microalbuminuria (UAE 30 to 300 mg/24 h) occurred in 26% of patients and was associated with higher diastolic blood pressure (DBP), left ventricular mass index (LVMI), and a higher prevalence of hypertriglyceridemia and hyperapolipoproteinemia B (apo-B). Logistic regression analysis showed that the risk of microalbuminuria was independently related to diastolic blood pressure and hypertriglyceridemia when controlling for age, sex, body mass index, LVMI, and apo-B. Multiple regression analysis likewise confirmed that both DBP and LVMI were linearly related to UAE independent of age, sex, body mass index, total cholesterol, triglycerides, and apo-B. In conclusion, our study indicates that among hypertensive patients with elevated excretion rates of urinary albumin, even at the subclinical level, an increased cardiovascular risk exists compared to normoalbuminuric patients with a similar blood pressure. Assessment of the presence of microalbuminuria may be useful in the evaluation and management of hypertension.
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PMID:Factors related to the presence of microalbuminuria in essential hypertension. 781 38

Microalbuminuria (urinary albumin excretion between 20 and 200 micrograms/min) and endothelial dysfunction coexist in patients with essential hypertension. To evaluate whether the two phenomena are related and the determinants of that association, we recruited 10 untreated males with essential hypertension and microalbuminuria without diabetes to be compared with an equal number of matched patients with essential hypertension excreting albumin in normal amounts and 10 normal controls. The status of endothelial function was inferred from circulating von Willebrand Factor antigen (vWF), a glycoprotein secreted in greater amounts when the vascular endothelium is damaged. vWF concentrations were higher in hypertensive patients with microalbuminuria than in hypertensive patients without and controls. Individual vWF and urine albumin-excretion values were correlated (r = 0.55, p < 0.002). Blood pressure correlated with both urinary albumin excretion and vWF. Left ventricular mass index and minimal forearm vascular resistances were comparable in patients with hypertension and higher than in controls; total and low-density lipoprotein cholesterol, triglycerides, lipoprotein-a, Factor VII, and plasminogen activator inhibitor-1 did not differ. Fibrinogen was higher and creatinine clearance lower in microalbuminurics. Albuminuria in essential hypertension may reflect systemic dysfunction of the vascular endothelium, a structure intimately involved in permeability, haemostasis, fibrinolysis, and blood pressure control. This abnormality may have important physiopathological implications and expose these patients to increased cardiovascular risk.
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PMID:Microalbuminuria and endothelial dysfunction in essential hypertension. 798 Jul 88

Proteinuria (protein excretion > 300 mg/d) is an independent risk factor for the development of cardiovascular disease and renal failure. The finding of persistent proteinuria in otherwise asymptomatic patients often precedes the development of arterial hypertension and renal failure. When proteinuria is accompanied by arterial hypertension, blood pressure control can decrease the quantity of protein excretion but not the incidence of proteinuria. In this sense, converting enzyme inhibitors seem to possess a higher capacity to reduce proteinuria. Nevertheless, the effects of reducing proteinuria on renal function and cardiovascular risk remain to be elucidated. Microalbuminuria (urine albumin excretion oscillating between 30 and 300 mg/d) seems to be a predictor of cardiovascular disease in diabetic and nondiabetic subjects and has been established as a predictor for the development of diabetic nephropathy. Blood pressure levels and urinary albumin excretion correlate positively, and antihypertensive therapy of any kind decreases the quantity of albumin present in the urine. The role of increased albumin excretion in essential hypertension and in renal failure remains to be elucidated.
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PMID:Clinical relevance of proteinuria and microalbuminuria. 792 40

Many patients with arterial hypertension have abnormal urinary excretion levels of albumin. This study was aimed at examining the effects of lisinopril and amlodipine on urinary excretion of albumin and kidney function. Thirty-six previously untreated patients with essential arterial hypertension were divided randomly into two groups. The first group received lisinopril 20 mg daily for 12 weeks followed by 10 mg amlodipine daily for another 12 weeks. The second group received 10 mg amlodipine daily for 12 weeks followed by 20 mg lisinopril daily for another 12 weeks. The arterial pressure decreased in a similar way with both therapies in both groups. In both groups urinary albumin excretion decreased in patients receiving lisinopril (p < 0.01). No significant changes were observed with amlodipine. This study shows that lisinopril, but not amlodipine, is able to reduce urinary excretion of albumin in patients with essential hypertension independently of its effective antihypertensive properties. It is probable that the positive effect of lisinopril on microalbuminuria is attributable to the modifications in intrarenal hemodynamics or to a change in glomerular permeability.
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PMID:Effects of lisinopril and amlodipine on microalbuminuria and renal function in patients with hypertension. 792 28

The development in recent years of sensitive assays specific for albumin has facilitated extensive investigation of the pathophysiology and clinical significance of microalbuminuria. It is now clear that the appearance of microalbuminuria represents a crucial event in the natural histories of diabetes mellitus and essential hypertension. It reflects the presence of generalized vascular damage and is strongly predictive of subsequent renal failure, cardiovascular morbidity, and death. Therapeutic interventions, including strict diabetic and blood-pressure control, can reduce microalbuminuria and improve the overall prognosis. The detection and treatment of microalbuminuria in these high-risk groups should now form an integral part of their management. Large-scale screening programmes are also recommended for insulin-dependent diabetics.
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PMID:Microalbuminuria: pathogenesis, prognosis and management. 795 79

To determine the prevalence of increased microalbuminuria (AER) in essential hypertension, we studied an omogeneous population comprehensive of 160 mild-moderate essential hypertensives (EH) and 30 normotensive controls. All subjects underwent measurement of AER and creatinine clearance (CCl) on the 24-hour urine collection, and of plasma renin activity (PRA). The 24-hour mean arterial pressure (24h-BP) was also obtained by non-invasive ambulatory BP monitoring. The EH were subdivided into subgroups on the basis of their AER values (less or over 11 micrograms/min). Among the 160 EH the prevalence of high AER levels was of 37.5% (n = 60), showing in this subgroup of EH a mean value of 29.5 +/- 4 micrograms/min. Moreover, in the whole population of 160 EH, AER was significantly correlated to 24h-diastolic BP (p < 0.05). The subgroup of 60 EH with AER > 11 micrograms/min showed also Ccl values higher than the other subgroup of EH (p < 0.02), while non significant differences between age, mean duration of EH, PRA, and 24h-BP, both systolic and diastolic, were observed. Our results lead to hypothesize that in essential hypertension there exists a subgroup of subjects characterized, in the early phase of disease, by high capillary glomerular pressure, GFR and microalbuminuria values.
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PMID:[Prevalence of microalbuminuria in recent-onset essential hypertension]. 800 46

In 84 patients with insufficiently treated essential hypertension (systolic blood pressure > or = 160 mmHg and/or diastolic blood pressure > or = 100 mmHg) and normal renal function (creatinine clearance Mean +/- SD = 114 +/- 22 ml/min/1.73 m2) the mean urinary albumin excretion was 39 +/- 19 mg/24h in comparison to 14 +/- 13 mg/24h (p < 0.001) in 10 healthy controls. In 39 of the hypertensive patients albumin excretion was increased (> 30 mg/24h urine) in a subclinical range (microalbuminuria). After 3 days of effective antihypertensive treatment (systolic blood pressure < 150 mmHg and diastolic blood pressure < 90 mmHg) the mean albumin excretion of the microalbuminuric patients decreased from 66 +/- 33 mg/24h to 44 +/- 28 mg/24h (p < 0.01). 27 of these hypertensive patients showed persistent microalbuminuria; in the other 12 patients with primary microalbuminuria the albumin excretion rate was normal now. In the patients with persistent microalbuminuria the prevalence of hypertensive retinopathy was 85% in comparison to only 33% in the patients with reversible microalbuminuria under intensified antihypertensive treatment (p < 0.01) and 31% in the patients with primary normoalbuminuria. The prevalence of coronary heart disease was 11% in the patients with normoalbuminuria and 29% in those with irreversible microalbuminuria (ns). Thus hypertensive patients with persistent but not with reversible microalbuminuria under short intensive antihypertensive therapy show a statistically significant higher prevalence of hypertensive retinopathy and therefore can be considered as an indicator of general microvascular damage in essential hypertension.
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PMID:High prevalence of hypertensive retinopathy and coronary heart disease in hypertensive patients with persistent microalbuminuria under short intensive antihypertensive therapy. 802 13

The present study was designed to evaluate the urinary albumin excretion in 62 patients with essential hypertension. None of them had prior proteinuria or history of nephropathy or uropathy. Patient data, blood pressure, proteinuria using Bradford's method, albuminuria by radial immunodiffusion, urinary SDS-PAA electrophoresis, plasma glucose, serum creatinine, serum cholesterol were determined. The urinary albumin excretion was significantly higher (p < 0.001) in the group of hypertensive patients (19.22 +/- 2.36 micrograms/min) compared to a group of 20 control subjects (4.17 +/- 0.67 microgram/min). Compared to a subgroup of hypertensive patients without ischemic heart disease (12.07 +/- 1.30 micrograms/min) microalbuminuria was higher (43.74 +/- +/- 5.74 micrograms/min; p < 0.001) in a subgroup of 14 patients with essential hypertension and ischemic heart disease with severe coronary events: unstable angina pectoris (9 patients), myocardial reinfarction (2 patients), ventricular arrhythmias (3 patients). A positive correlation between the microalbuminuria and the duration of hypertension was found (r = 0.64; p < 0.001). Therefore, microalbuminuria may represent a marker of the severity of vascular involvement in hypertensive patients.
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PMID:Microalbuminuria in hypertensive patients. 808 6

The prevalence and determinants of urinary albumin excretion rate (AER) were assessed in lean and overweight normotensive subjects (NT) and patients with essential hypertension (EH). In NT and EH, the presence of overweight was associated with a significant exacerbation of AER. In the normotensive population, AER was higher in subjects with a positive family history of hypertension. An important role for smoking was observed in the hypertensive population; in fact, the prevalence of microalbuminuria (MA) was almost twofold in lean hypertensive smokers when compared to nonsmokers. Among other determinants of AER, a major influence of systolic arterial pressure, urinary excretion of urea (an estimate of protein intake), and high-density lipoprotein (HDL) cholesterol (inversely correlated with AER) was observed mainly in lean EH patients. The significance of microalbuminuria is unclear. Is it a marker of cardiovascular risk and/or a predictor of the future development of renal disease in EH?
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PMID:Albuminuria in normals and essential hypertension. 808 50

Microalbuminuria in the general population is associated with recognized risk factors for cardiovascular disease such as hypertension, hyperglycemia, hyperinsulinemia, and hyperlipidemia; and it is an independent predictor of subsequent cardiovascular mortality in hypertensive, diabetic, and elderly populations. Although different methods have been used for measuring and expressing urinary albumin excretion and a variety of cutoff levels have been used for defining microalbuminuria, prevalence of microalbuminuria appears to be higher in non-Europeans (8%-28%) than in Europeans (2%-10%). However, because of the large within-individual variability of urinary albumin excretion and the relatively low prevalence of microalbuminuria, large studies are required to detect statistically significant associations between albuminuria and cardiovascular risk factors. Evidence presented here supports the proposition that microalbuminuria represents a marker of cardiovascular disease risk in nondiabetic individuals as well as diabetic individuals. Moreover, because of a high sensitivity of the test and because albuminuria is a concomitant of many forms of renal disease, microalbuminuria also has a role in detecting patients with renal involvement associated with essential hypertension, lupus erythematosus, women with pre-eclampsia, and subjects with unsuspected primary and secondary nephropathies.
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PMID:Epidemiology of microalbuminuria in the general population. 808 51


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