MICROALBUMINURIA IN TREATED HYPERTENSIVE MEN AT HIGH-RISK OF CORONARY-DISEASE

Objective: To examine whether microalbuminuria is a marker of cardiova scular disease in treated hypertensive men without diabetes mellitus a t high coronary risk and to examine the associations between microalbu minuria and recognized cardiovascular risk factors. Design: Cross-sect ional study. Setting: Outpatient clinic in city hospital. Patients: Th ree hundred and thirty-three treated hypertensive men, aged 50-72 year s, either with a serum cholesterol of greater-than-or-equal-to 6.5 mmo l/l or smokers, or both. The patients were recruited mainly from a pop ulation-based sample of hypertensive men. Patients with diabetes melli tus or overnight urinary albumin excretion of >100mg/12h were excluded from the analyses. Main outcome measures: Overnight urinary albumin e xcretion, prevalence of microalbuminuria (defined as 17-100 mg/12h) an d organ damage (cardiovascular events or major electrocardiogram chang es, or both), various well-established risk factor levels, blood gluco se and plasma insulin responses to an oral glucose tolerance test. Res ults: Microalbuminuria was found in 25% of the cohort. Among microalbu minuric patients, organ damage was significantly more common (47.6%) t han in the normoalbuminuric group (30.9%). However, the sensitivity an d specificity of microalbuminuria as a marker of organ damage were onl y 34 and 80%, respectively. Microalbuminuria was significantly related to body mass index and waist:hip ratio, age and plasma insulin during oral glucose tolerance testing. These relationships also persisted af ter adjustment for treatment with thiazides or beta-blockers. Conclusi ons: In treated hypertensive men without diabetes mellitus, microalbum inuria was associated with factors known to be related to insulin resi stance. It had a low sensitivity as a marker of concomitant cardiovasc ular disease.