The relations of microalbuminuria to ambulatory blood pressure and myocardial wall thickness in a population

Objectives. To examine the relationship between microalbuminuria (20-200 mu g min(-1)) and 24 h ambulatory blood pressure and heart wall thickness, in a representative population sample of men and women aged 56-65 years, Design. Every second individual aged 56-65 years (n = 488) in the district, was invited for a health examination, which included determination of urinary albumin and creatinine (overnight sample). The highest and lowest decentile of urinary albumin/creatinine ratio were compared, Setting. The district of the Primary Health Care and Research Centre of Molnlycke, Sweden, Subjects. After excluding 2 individuals with a urinary albumin excretion exceeding 200 mu g min(-1), 26 subjects (group 1) could be compared with 27 subjects in the lowest decentile (group 2), Main outcome measures. Comparison between the determinations of the ambulatory blood pressure and echocardiographic variables in the two groups. Results. Group 1 had significantly higher 24 h ambulatory blood pressure, and heart septum and posterior wall thickness as well as significantly higher fasting blood glucose and serum triglyceride concentrations. The differences in blood pressure (P < 0.05) but not heart wall thickness remained significant (P < 0.05) after excluding subjects with hypertension, angina pectoris, treated diabetes mellitus, and/or history of heart or cerebrovascular disease. When excluding individuals with both treated and untreated diabetes mellitus, fasting blood glucose concentration was higher in group 1. The waist-hip ratio, weight and body mass index did not differ between the groups. Conclusions. The findings indicate that microalbuminuria is related to signs of cardiovascular and metabolic influence and therefore could be a valuable tool for grading the risk of later cardiovascular morbidity.