Prevalence and determinants of microalbuminuria in high-risk diabetic and nondiabetic patients in the heart outcomes prevention evaluation study

OBJECTIVE - To describe the characteristics of diabetic and nondiabetic par ticipants in the Heart Outcomes Prevention Evaluation (HOPE) Study who are at high risk of developing cardiovascular (CV) disease and who have microal buminuria (MA), and to identify the key determinants of MA in these two gro ups. RESEARCH DESIGN AND METHODS - Albuminuria was measured in 97% of patients e nrolled in the HOPE Study as part of the MICRO-HOPE (MA, CV, and Renal Outc omes in HOPE) substudy. Baseline clinical characteristics of diabetic and n ondiabetic participants with MA were recorded, and the univariate and multi variate relationship between these characteristics and the presence of MA w as estimated for both groups. RESULTS - Baseline urinary albumin determinations were available in 3,574 ( 97.8%) diabetic participants and 5,708 (97.0%) nondiabetic participants. MA was detected in 1,151 (32.2%) diabetic participants and 837 (14.7%) nondia betic participants. Age, waist-to-hip ratio, diabetes, smoking, hypertensio n, vascular disease, and left ventricular hypertrophy were independent dete rminants of MA in all participants. In diabetic participants, the odds of M A increased 16% for every 10.4 years of diabetes duration, and increased 8% for every 0.9% increase in glycated hemoglobin (assuming a GHb assay with an upper limit of 6% in the nondiabetic range). CONCLUSIONS - MA is independently associated with several risk factors for CV and renal disease in both diabetic and nondiabetic individuals at high r isk for CV disease.