RISK-FACTORS THAT PREDICT DEVELOPMENT OF MICROALBUMINURIA IN TREATED HYPERTENSIVE MEN

The aim of this prospective study was to investigate the risk factors for development of microalbuminuria in treated hypertensive men with a nd without diabetes mellitus. Two hundred and ninety-seven treated hyp ertensive men, aged fifty to seventy-two years, with at least one of t he following: serum cholesterol greater than or equal to 6.5 mmol/L, s moking, or diabetes mellitus, were included in the study. Patients wit h elevated overnight urinary albumin excretion (>17 mg/12 hr) were. ex cluded. Urinary albumin excretion (UAE), blood pressure, and various w ell-established risk factor levels were measured. Two hundred thirteen nondiabetic patients and 40 patients with diabetes mellitus completed the three-year follow-up. Development of microalbuminuria was more pr evalent in those with diabetes mellitus at baseline compared with the group without diabetes mellitus, 25% and 10.3%, respectively (P = 0.02 ). Nondiabetic patients who developed microalbuminuria had higher UAE, 10.2 mg +/-3.7 and 5.7+/-3.2, respectively (P < 0.0001), and higher s ystolic blood pressure 160 mm Hg +/-27 and 152+/-17, respectively (P = 0.043), at baseline compared with whose who remained normoalbuminuric . In the group with diabetes mellitus, a higher UAE, 9.8+/-2.7 and 7.1 +/-3.6, respectively (P = 0.036), at baseline was observed in whose wh o developed microalbuminuria compared with whose who remained normoalb uminuric. In conclusion, concomitant diabetes mellitus significantly i ncreased the risk for development of microalbuminuria during the three -year follow-up in treated hypertensive men. Patients who progressed t o microalbuminuria had higher UAE at baseline, but still within the no rmoalbuminuric range, compared with those who remained normoalbuminuri c. Systolic blood pressure at baseline was higher in those who progres sed to microalbuminuria, although reaching statistically significance only in the larger nondiabetic group.