URINARY ALBUMIN EXCRETION AND ATHEROSCLEROSIS IN ESSENTIAL-HYPERTENSION

1. Increased urinary albumin excretion is common in patients with esse ntial hypertension and is at least to some extent correlated with prev ailing blood pressure levels, However, the generalized vascular dysfun ction present in advanced atherosclerotic disease may independently in fluence this parameter. 2. To evaluate this possibility, we assessed b lood pressure, ultrasonographic carotid thickness, cardiac mass, minim um forearm vascular resistances, metabolic parameters and the angioten sin-converting enzyme genotype in patients with untreated essential hy pertension and atherosclerotic peripheral vascular disease (n = 11), T he results were compared with similar data obtained in matched groups of patients,vith uncomplicated hypertension and,vith normotensive cont rol subjects (n = 11 per group). 3. Urinary albumin excretion was high er in hypertensive patients with atherosclerosis than in those without complications; carotid thickness was higher in atherosclerotic patien ts and a positive, statistically significant correlation existed betwe en this parameter and urinary albumin excretion, In the same patient g roup, systolic blood pressure, fasting insulin and triacylglycerol lev els were elevated and correlated with urinary albumin levels, However, differences in urinary albumin excretion persisted after taking into account the influence of those parameters by analysis of covariance. T he distribution of angiotensin-converting enzyme genotype patterns and values of cardiac mass and minimum forearm vascular resistances did n ot differ significantly among the experimental groups. 4. The data sug gest that vascular status may influence urinary albumin excretion in p atients with essential hypertension, while confirming the importance o f systolic blood pressure levels as a determinant of the raised urinar y albumin excretion.