DOES MICROALBUMINURIA PREDICT CARDIOVASCULAR EVENTS IN NONDIABETIC MEN WITH TREATED HYPERTENSION

The aim of this study was to investigate the predictive value of micro albuminuria (overnight urinary albumin excretion rate 17 to 100 mg/12 h) as a risk factor for future major cardiovascular events in nondiabe tic patients with treated hypertension in a prospective study with fol low-up time of 3.3 years. Overnight urinary albumin excretion was meas ured in 345 nondiabetic treated hypertensive men, aged 50 to 72 years, either with a serum cholesterol of greater than or equal to 6.5 mmol/ L or smokers, or both. Cardiovascular morbidity was closely recorded d uring the follow-up period. At entry, microalbuminuria was found in 84 patients (24.3%) and 12 patients had macroalbuminuria (3.5%). During the follow-up period there were no differences in new cardiovascular e vents between patients with microalbuminuria and those with normoalbum inuria. However, an increase in the risk of future major cardiovascula r events occurred in patients with urinary albumin excretion above 100 mg/12 h (macroalbuminuria). In a Cox regression analysis urinary albu min excretion was not associated with the incidence of future major ca rdiovascular events unless a more detailed approach was used, showing that this was the case for urinary albumin excretion above 100 mg/12 h (macroalbuminuria). Calculations with an alternative definition of mi croalbuminuria and mortality as end-point did not change the principal result. In conclusion, microalbuminuria does not seem to be a predict or of future mortality and cardiovascular morbidity in nondiabetic men with treated hypertension and at high risk of coronary heart disease. However, macroalbuminuria was associated with future major cardiovasc ular events in this group of patients.