Document Detail


Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives.
MedLine Citation:
PMID:  21220713     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Microalbuminuria is a known marker of subclinical organ damage. Its prevalence is higher in patients with resistant hypertension than in subjects with blood pressure at goal. On the other hand, some patients with apparently well-controlled hypertension still have microalbuminuria. The current study aimed to determine the relationship between microalbuminuria and both office and 24-hour ambulatory blood pressure. A cohort of 356 patients (mean age 64 ± 11 years; 40.2% females) with resistant hypertension (blood pressure ≥ 140 and/or 90 mm Hg despite treatment with ≥ 3 drugs, diuretic included) were selected from Spanish hypertension units. Patients with estimated glomerular filtration rate <30 mL/min/1.73 m(2) were excluded. All patients underwent clinical and demographic evaluation, complete laboratory analyses, and good technical-quality 24-hour ambulatory blood pressure monitoring. Urinary albumin/creatinine ratio was averaged from 3 first-morning void urine samples. Microalbuminuria (urinary albumin/creatinine ratio ≥ 2.5 mg/mmol in males or ≥ 3.5 mg/mmol in females) was detected in 46.6%, and impaired renal function (estimated glomerular filtration rate <60 mL/min/1.73 m(2)) was detected in 26.8%. Bivariate analyses showed significant associations of microalbuminuria with older age, reduced estimated glomerular filtration rate, increased nighttime systolic blood pressure, and elevated daytime, nighttime, and 24-hour diastolic blood pressure. In a logistic regression analysis, after age and sex adjustment, elevated nighttime systolic blood pressure (multivariate odds ratio, 1.014 [95% CI, 1.001 to 1.026]; P=0.029) and reduced estimated glomerular filtration rate (multivariate odds ratio, 2.79 [95% CI, 1.57 to 4.96]; P=0.0005) were independently associated with the presence of microalbuminuria. We conclude that microalbuminuria is better associated with increased nighttime systolic blood pressure than with any other office and 24-hour ambulatory blood pressure monitoring parameters.
Authors:
Anna Oliveras; Pedro Armario; Nieves Martell-Clarós; Luis M Ruilope; Alejandro de la Sierra;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-01-10
Journal Detail:
Title:  Hypertension     Volume:  57     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-04-14     Revised Date:  2011-06-07    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  556-60     Citation Subset:  IM    
Affiliation:
Hypertension Unit, Nephrology Department, Hospital Universitari del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain. aoliveras@hospitaldelmar.cat
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / complications,  physiopathology,  urine*
Analysis of Variance
Blood Pressure*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology*
Female
Glomerular Filtration Rate
Humans
Hypertension / complications,  physiopathology,  urine*
Kidney / physiopathology
Kidney Function Tests
Logistic Models
Male
Middle Aged
Odds Ratio
Sex Factors
Investigator
Investigator/Affiliation:
Pedro Aranda / ; Pedro Armario / ; Carlos Calvo / ; Juan Antonio Divisón / ; Pablo Gómez / ; Raquel Hernández del Rey / ; Anna Oliveras / ; Alejandro Roca-Cusachs / ; Luis M Ruilope / ; Carlos Sanchís / ; Julián Segura / ; Alejandro de la Sierra / ; Carmen Suárez / ; María Abad / ; María Jesús Adrián / ; Javier Andrés / ; Pedro Armario / ; Jesús María Arteaga / ; Mario Luis Ávila / ; Sonia Blanco / ; Josep Bonet / ; Carlos Calvo / ; Mari Cruz Carreño / ; Eva María Cotilla / ; Luis Miguel Cuadrado / ; Alejandro de la Sierra / ; Leyre Díez / ; Juan Antonio Divisón / ; Mónica Doménech / ; María Jesús Eiris / ; Vicente Esteve / ; Angela Felip / ; Gema Fernández-Fresnedo / ; Patrícia Fernández-Llama / ; Celia Fernández / ; José Antonio García / ; Vicente Giner / ; Pablo Gómez / ; Javier Guerediaga / ; Fernando Gutiérrez / ; Raquel Hernández-del Rey / ; Pedro Horcajo / ; Julio Jorge / ; Pedro Jesús Labrador / ; Ignacio Lekuona / ; Antonio Liébana / ; María Dolores López / ; Dolores Lorenzo / ; Antonia Maldonado / ; María José Manzanera / ; Nieves Martell-Clarós / ; Jesús Martín / ; Isabel Olmos / ; Aitor Parra / ; José Manuel Pascual / ; Antonio Pedreira / ; Gonzalo Pia / ; Mar Piedecausa / ; Luis Angel Prieto / ; José Neldo Prieto / ; Josep Redón / ; Nicolás Roberto Robles / ; Alejandro Roca-Cusachs / ; Jordi Roig / ; Eduardo Rovira / ; José Saban / ; Juan Francisco Sánchez / ; Pilar Sánchez / ; Julián Segura / ; Javier Sobrino / ; Carmen Suárez / ; Javier Tisaire / ; Pere Torguet / ; Jesús Toril / ; Santiago Torreira / ; Susana Vázquez / ; Ana Veiga / ; Vigil Luis / ; José Ovidio Yáñez /
Comments/Corrections
Comment In:
Hypertension. 2011 May;57(5):e20; author reply e21   [PMID:  21464393 ]

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