Prevalence, characteristics and predictive factors of microalbuminuria in resistant systemic arterial hypertension

Abstract

The present cross-sectional observational study was made in family medicine offices of Timi' County, Romania. The aim of the study was to investigate the prevalence of urinary microalbumin excretion (MAU) in resistant systemic arterial hypertension (RH), to analyze patients' biochemical and clinical characteristics, and the predictive factors for MAU. From a total number of 347 patients, MAU was detected in 76 cases (21.9%). The microalbuminuria positive patients were older, with significant higher office systolic blood pressure (BP) (155 ± 13.50 vs 148 ± 12.40 mmHg, p < 0.0001) and diastolic blood pressure (94 ± 12.20 vs 88 ± 14.6 mmHg, p = 0.0013), higher prevalence of left ventricular hypertrophy, diabetes mellitus, obesity, ischemic and peripheral arterial disease. MAU positive patients presented statistical significant differences in biochemical data concerning: fasting plasma glucose (FPG) (118.80 ± 32.02 vs 108.01 ± 26.01 mg/dL, p = 0.003), impaired glucose tolerance (IGT) (10.52 % vs 4.94 %), glycated hemoglobin (HbA1c) (6.56 ± 0.98% vs 5.96 ± 0.91%, p < 0.001), reduced estimated glomerular filtration rate (EGFR) (56.10 ± 15.4 vs 69.30 ± 17.5 ml/min/1.73m2, p < 0.001) and higher potassium levels (4.71 ± 0.43 vs 4.59 ± 0.44 mg/dL, p = 0.0378). No significant differences were noticed regarding LDL-and HDL-cholesterol, triglycerides, uric acid and serum creatinine. In a logistic multivariate analysis independent predictors for MAU were: systolic BP (odds ratio, OR = 1.024, 95% confidence interval, CI:1.011-1.039, p < 0.001), HbA1c (OR = 1.324, 95% CI: 1.078-1.724, p = 0.008) and EGFR (OR = 0.989, 95% CI: 0.977-0.999, p = 0.01). Our findings suggest that an important part of RH patients have microalbuminuria and highlight the importance of controlling its predictors, in order to improve patients' outcome.