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

J Intern Med. 2004 Jul;256(1):22-9. doi: 10.1111/j.1365-2796.2004.01338.x.


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 > or = 20 microg 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 (beta = 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / physiopathology*
  • Aorta / physiopathology*
  • Blood Flow Velocity
  • Blood Pressure Monitoring, Ambulatory
  • Carotid Arteries / physiopathology
  • Cross-Sectional Studies
  • Elasticity
  • Female
  • Femoral Artery / physiopathology
  • Humans
  • Hypertension / physiopathology*
  • Hypertension / urine*
  • Male
  • Middle Aged
  • Pulse
  • Regression Analysis
  • Risk Factors