Document Detail


High normal levels of albuminuria and risk of hypertension in Indo-Asian population.
MedLine Citation:
PMID:  21592974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Urine albumin excretion in the high normal range [urine albumin to creatinine ratio (UACR) 10-29 mg/g)] predicts hypertension in European-origin populations. However, the prognostic significance of UACR in the high normal range for incident hypertension is unclear in Indo-Asians. The objective of this study was to examine the relationship of normal to high normal levels of UACR and incident hypertension.
METHODS: We conducted a nested cohort study within a cluster randomized controlled trial in Pakistan on 1272 normotensive non-diabetic adults aged ≥ 40 years with UACR <30 mg/g. Incident hypertension was defined as new onset of systolic blood pressure (SBP) ≥ 140 mmHg or diastolic ≥ 90 mmHg or initiation of antihypertensive therapy.
RESULTS: A total of 920 (72.3%) participants completed the 2-year final follow-up. During this time, 105 (11.4%) developed incident hypertension. In the multivariable model, the odds [95% confidence interval (CI)] for incident hypertension were 2.45(1.21-4.98) for those in the fourth (top) quartile (≥ 6.1 mg/g) and 2.12 (1.04-4.35) in the third quartile (3.8-6.1 mg/g) compared to those in the lowest quartile (<2.8 mg/g). In addition, a significant interaction between UACR and baseline SBP was observed suggesting that the odds (95% CI) of incident hypertension with UACR were greater at lower baseline SBP (interaction P = 0.044).
CONCLUSIONS: High normal levels of albuminuria as measured by UACR predict hypertension in non-diabetic Indo-Asians, and this relationship may be enhanced in individuals with low baseline SBP. Further research is needed to assess the clinical applicability of these findings.
Authors:
Saleem Jessani; Andrew S Levey; Nish Chaturvedi; Tazeen H Jafar
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-05-17
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  27 Suppl 3     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-11-01     Completed Date:  2013-04-25     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  iii58-64     Citation Subset:  IM    
Affiliation:
Clinical Epidemiology Unit, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. tazeen.jafar@aku.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Albuminuria / complications*
Asian Continental Ancestry Group
Biological Markers / urine
Blood Pressure
Cohort Studies
Creatinine / urine*
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension / epidemiology,  etiology*
Male
Middle Aged
Pakistan / epidemiology
Prognosis
Reference Values
Risk Factors
Grant Support
ID/Acronym/Agency:
070854/Z/03/Z//Wellcome Trust; 1R03TW007588-01A1/TW/FIC NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 60-27-5/Creatinine
Comments/Corrections

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