ALBUMINURIA IN NORMOTENSIVE AND HYPERTENSIVE INDIVIDUALS ATTENDING OFFICES OF GENERAL-PRACTITIONERS

Objective To investigate the rate of albumin excretion and the prevale nce of albuminuria in hypertensive individuals relative to the normote nsive population, and to clarify the quantitative importance of confou nding variables. Design and methods We examined the morning urines of all consecutive non-diabetic and diabetic hypertensive patients (n = 6 31; 371 women, 260 men) attending the offices of five general practiti oners in a circumscribed geographical area during a 4-month period. To obtain a normotensive control population, all consecutive visitors (n = 375; 217 women, 158 men) were also examined. Urinary albumin excret ion was assessed by kinetic nephrelometry in morning urine samples. Re sults The median albumin excretion rate was 4.3 mu g/ml (range 1.9-112 ) in normotensive individuals; 3.4 mu g/ml (1.9-1440) in hypertensive and 3.6 mu g/ml (1.9-2790) in diabetic patients (n = 189; 115 women, 7 4 men). The overall prevalence of albuminuria above 20 mu g/ml was 4% in normotensive individuals, 10% in hypertensive patients and 17%, in diabetic patients. The proportion of patients with higher-grade albumi nuria (> 50 mu g/ml) was 1% among the normotensive subjects aged below 60 years and 2% in those aged above 60 years; the respective values i n hypertensive patients were 3 and 6% and in diabetic patients 8 and 1 3%. The multivariate regression analysis showed a significant correlat ion between albuminuria and smoking (P < 0.0001), the presence of hype rtension (P < 0.001), the current level of systolic blood pressure (P < 0.01) and age (0.031), but not sex or body mass index. Conclusions T he present study confirms a higher prevalence of albuminuria above 20 mu g/ml in individuals with primary hypertension and diabetes mellitus compared with that in normotensive subjects, despite similar median a lbumin excretion rates. However, the excess of prevalence is moderate. Smoking,advanced age and current level of systolic blood pressure are the important determinants.