Document Detail

ADMA, C-reactive protein, and albuminuria in untreated essential hypertension: a cross-sectional study.
MedLine Citation:
PMID:  20189274     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Asymmetric dimethylarginine (ADMA) and subclinical inflammation are associated with atherosclerosis progression, whereas microalbuminuria is an established index of hypertensive organ damage. STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: In an outpatient hypertensive unit, 296 nondiabetic and untreated participants with hypertension were studied. Participants with atherosclerotic cardiovascular disease, severe valvulopathy, congestive heart failure, presence of neoplastic or other concurrent systemic disease, atrial fibrillation, serum creatinine level > 1.5 mg/dL in men and > 1.4 mg/dL in women, and urinary albumin excretion > 300 mg/24 h were excluded. PREDICTORS: ADMA and high-sensitivity C-reactive protein (hs-CRP) levels. OUTCOME VARIABLE: Albuminuria assessed using albumin-creatinine ratio (ACR). MEASUREMENTS: Participants underwent ambulatory blood pressure monitoring, echocardiography, routine assessment of metabolic profile, ADMA, and hs-CRP, whereas ACR was determined as the mean of 3 values in nonconsecutive morning spot urine samples. RESULTS: 64 participants had an ACR of 30-300 mg/g. Stratification based on ADMA level showed that participants with hypertension in quartile [Q] 4 compared with those in Q3, Q2, and Q1 showed the highest ACRs (53.2 vs 31.2 vs 30.4 vs 16.7 mg/g; P < 0.008 for all). Moreover, stratification based on hs-CRP level showed that participants with hypertension in Q4 (69.8% had microalbuminuria) showed the highest ACRs (72.2 vs 25.6, 16.2, and 19.2 mg/g for Q3, Q2, and Q1, respectively; P < 0.008 for all). Stepwise regression analysis showed that age, 24-hour systolic blood pressure, hs-CRP level, ADMA level, and the interaction of hs-CRP with ADMA were independent predictors of ACR (R(2) = 0.674; P < 0.001). LIMITATIONS: Cross-sectional study. CONCLUSIONS: In patients with untreated essential hypertension, increased hs-CRP and ADMA levels are associated with microalbuminuria, suggesting the involvement of inflammation and endothelial dysfunction in vascular and kidney damage.
Costas Tsioufis; Kyriakos Dimitriadis; Eirini Andrikou; Costas Thomopoulos; Dimitris Tsiachris; Elli Stefanadi; Costas Mihas; Antigoni Miliou; Vassilios Papademetriou; Christodoulos Stefanadis
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Publication Detail:
Type:  Journal Article     Date:  2010-02-26
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  55     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1050-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 National Kidney Foundation, Inc. All rights reserved.
First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
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MeSH Terms
Albuminuria / metabolism*,  physiopathology
Arginine / analogs & derivatives*,  metabolism
Blood Pressure / physiology
C-Reactive Protein / metabolism*
Creatinine / metabolism
Cross-Sectional Studies
Endothelium, Vascular / physiopathology
Hypertension / metabolism*,  physiopathology
Inflammation / physiopathology
Middle Aged
Regression Analysis
Serum Albumin / metabolism
Reg. No./Substance:
0/Serum Albumin; 30315-93-6/N,N-dimethylarginine; 60-27-5/Creatinine; 74-79-3/Arginine; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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