URINARY ALBUMIN EXCRETION - A PREDICTOR OF RISK OF CARDIOVASCULAR-DISEASE - A PROSPECTIVE 10-YEAR FOLLOW-UP OF MIDDLE-AGED NONDIABETIC NORMAL AND HYPERTENSIVE MEN

To study how the risk of cardiovascular disease changes with increasin g levels of urinary albumin excretion (UAE), we prospectively studied a random sample of 120 49-year-old men with a wide range of blood pres sures Based on diastolic blood pressure (DBP), the subjects were divid ed into normotensives (DBP < 90 mm Hg; n = 21), borderline hypertensiv es (DBP 90 to 94 mm Hg; n = 30), mild hypertensives (DBP 95 to 104 mm Hg; n = 45) and moderate to severe hypertensives (DBP > 105 mm Hg; n = 24). None had been previously treated for hypertension or had seconda ry hypertension, diabetes mellitus, or other cardiovascular diseases a t baseline. Heart and kidney function and metabolic and hormonal varia bles were also studied. The hypertensives were treated with beta-block ade, diuretics, or hydralazine. The cardiovascular morbidity during 10 years of follow-up was studied. The 19 subjects who developed cardiov ascular disease had significantly higher baseline UAE than the group t hat did not (median value 16.6 mg/24 h; range 3.5 to 73, and 9.7 mg/24 h, range 0 to 308, respectively), UAE correlated to systolic blood pr essure (P = .0115) and DBP (P = .031), but not to smoking behavior or serum cholesterol. The risk of cardiovascular disease was associated w ith UAE and smoking independently of blood pressure (P = .001 and P = .015, respectively), and the risk increased continuously with increasi ng UAE. The initial UAE thus emerged as an efficient and independent p redictor of cardiovascular disease in middle-aged hypertensive and nor motensive men. UAE appeared to be a stronger predictor than blood pres sure and serum cholesterol.