Medicine in evolution








- Abstract -

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.



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