Increased LDL/HDL ratio but not elevated levels of von Willebrand factor antigen as characteristic feature in patients with essential hypertension and moderate microalbuminuria

Microalbuminuria reflects a diffuse vascular damage and predicts cardiovasc ular morbidity and mortality in patients with essential hypertension. In se veral studies microalbuminuria of hypertensive patients was associated with atherogenic Lipid profile and elevated levels of the von Willebrand factor produced by a dysfunctional endothelium. In this study we compared the lip id profile and the LDL/HDL ratio as vascular risk factor as well as the von Willebrand factor as marker of endothelial dysfunction in 14 non-diabetic patients with essential hypertension and microalbuminuria and in 36 hyperte nsive patients with normoalbuminuria. In addition, we evaluated the prevale nce of micro- and macro-angiopathic damages and complications in both group s of patients. The hypertensive patients with microalbuminuria showed a sig nificantly higher LDL/HDL ratio (3.6 +/- 0.5 versus 2.9 +/- 0.4, p < 0.05) than the normoalbuminuric patients; the Levels of the von Willebrand factor was comparable high in both patient groups. The prevalence of hypertensive retinopathy (71% versus 28%, p < 0.01) and of coronary heart disease (43% versus 11%, p < 0.05) was significantly higher in the microalbuminuric pati ents. Thus, in patients with essential hypertension and microalbuminuria an atherogenic Lipid profile and a higher prevalence of micro- and macroangio pathic vascular diseases can be seen. An elevation of the von Willebrand fa ctor levels as marker of endothelial dysfunction may be expected in a more advanced stage of microalbuminuria.