Relationship between albumin excretion rate, ambulatory blood pressure and left ventricular hypertrophy in mild hypertension

OBJECTIVETo study the relationship of urinary albumin excretion to ambulatory blood pressure and other cardiovascular risk factors in borderline to mild hypertension. PATIENTS AND METHODSWe studied 779 patients with borderline to mild hypertension (mean±SEM age 33±0.3 years; mean±SEM office blood pressure 146±0.4/94±0.2 mmHg) at 17 hypertension clinics in northeast Italy. Office and 24-h blood pressures were recorded with simultaneous urine collection for albumin measurement. In 510 subjects, left ventricular mass was measured by echocardiography. RESULTSSubjects with overt (>30 mg/24 h) and borderline (16–29 mg/24 h) microalbuminuria had similar 24-h blood pressure levels, higher than those in the subjects without microalbuminuria. In the univariate and multiple regression analyses the albumin excretion rate was closely correlated with 24-h systolic blood pressure and not related to age, body mass index, metabolic parameters, lifestyle factors and degree of left ventricular hypertrophy. CONCLUSIONSBorderline values of urinary albumin excretion (16–29 mg/24 h) may be clinically relevant in subjects with borderline to mild hypertension. Renal and cardiac damage do not develop in parallel in the initial phases of hypertension.