Microalbuminuria, cardiovascular disease and risk factors in a nondiabetic/nonhypertensive population.: The Nord-Trondelag Health Study (HUNT, 1995-97), Norway

Objective. Microalbuminuria (MA) as an independent marker of cardiovascular morbidity and mortality in nondiabetic/nonhypertensive individuals is under international debate. The aim of this study was to investigate the associations between MA and known cardiovascular risk factors/markers and disease in a randomly selected nondiabetic/nonhypertensive sample. Design. Cross-sectional study. Setting. Participants in the population-based Nord-Trondelag Health Study (HUNT), Norway (n = 65 258). Subjects. A total of 2113 individuals (greater than or equal to20 years), randomly selected without diabetes and treated hypertension, delivered three morning urine samples for MA analysis. Main outcome measures. MA expressed as albumin-to-creatinine ratio (ACR), cardiovascular risk factors and disease. Results. Increasing age, pulse pressure, systolic (SBP) and diastolic blood pressure (DBP) and coronary heart disease (CHD) significantly predicted MA in men and increasing pulse pressure, SBP and DBP were associated with MA in women, adjusted for other cardiovascular risk factors/markers. After excluding individuals with known CHD and untreated hypertension (SBP greater than or equal to 140 mmHg, DBP greater than or equal to 90 mmHg) and hence a high total risk of cardiovascular disease (CVD), only increasing age was associated with ACR in men and increasing SBP and pulse pressure in women. Smoking, elevated lipid and glucose levels were strongly associated with MA in individuals with a high total risk of CVD than in individuals with a low total risk. Conclusion. MA was associated with increasing blood pressure in both genders, age and CHD in men. Other cardiovascular risk factors/markers might be more influential in predicting ACR variation in nondiabetic/nonhypertensive individuals with a high total risk of CVD than in individuals with a low total risk.