In essential hypertension
microalbuminuria and left ventricular hypertrophy
reflect target organ damage. Both are related to the
level of blood pressure and they are associated with
an increase in morbidity and mortality. We analysed
the database for patients with essential
hypertension of five family medicine offices. Our
objective was to determine the level of association
between microalbuminuria and left ventricular
hypertrophy, which might explain the observed
increase in morbidity and mortality in these
patients.
Materials and methods:
After the exclusion of patients with secondary
hypertension, renal disease and diabetes mellitus,
patients with complete data for microalbuminuria
measurement, left ventricular mass (LVM) and 24 h
blood pressure monitoring were selected. Data were
complete for 258 patients 126 (49.9%) female and 132
male (51.1%), with age between 35 and 59 years
(middle age 47±12 years). Of these, a number of 98
(38%) had a positive test for microalbuminuria,
measured semi quantitatively by urine test strips.
Results:
Microalbuminuria was positively related to 24 h
systolic blood pres¬sure and weight and was
negatively related to age. Left ventricular mass was
higher in patients with microalbuminuria (at men 265
± 69 g; at women 207 ± 61 g), than in those without
(men 250±64 g, p < 0.05; women 185±50 g, p < 0.001).
After correction for the effects of gender, body
mass index and 24 h systolic blood pressure, the
presence of microalbuminuria was associated with an
increase in LVM of 9.8 g (P < 0.05, 95%).
Conclusion:
microalbuminuria is associated with an increase in
LVM in patients with essential hypertension,
independent of other known determinants.
Key words:
essential hypertension, blood pressure monitoring,
left ventricular hypertrophy, microalbuminuria.