Study of factors related with changes of microalbuminuria during antihypertensive treatment

BACKGROUND: The objective of the present study was to analyze the factors r elated with changes of microalbuminuria during antihypertensive treatment i n patients with essential hypertension. METHODS: One hundred and six patients (57 men, mean age 40.8 [SD 6.6] years ) never treated with antihypertensive treatment were included. At the begin ning and after one year, blood pressure biochemical profile and urinary alb umin excretion (UAE) were measured. After the initial evaluation, 53 patien ts received angiotensin converting enzyme inhibitors (ACEi) and 53 beta-blo ckers (BB). Hidroclothiazide was added to achieve the blood pressure target < 140/90 mmHg. RESULTS: The average of UAE was 32.1 (43.1) mg/24 h, and 41 (39%) patients had microalbuminurics. After 12 months of treatment, a significative fall o f systolic BP (-20.6 [8.03] mmHg, p < 0.001), and diastolic BP (-14.18 [10. 34] mmHg, p < 0.001) were observed, whereas baseline glucose increases (3.0 8 [11.07] mg/dl, p = 0.006). The changes of UAE were only related with the baseline UAE values. Neither, age, sex, baseline diastolic BP and changes i n diastolic BP were significantly related with the changes in UAE. In spite of similar mean BP reduction (medial BP 17.4 [10.9] vs 14.8 [10.4] mmHg). UAE only was reduced in patients treated with ACEi (LogUAE: 0.203[0.872] mg /24 h; p < 0.04). In addition, in patients treated with BE a significative increase in baseline glucose (4.4 [12.3] mg/dl; p = 0.013) and uric acid (1 .18 [4.18]; p = 0.031) were observed. CONCLUSIONS: In patients with essential hypertension, changes in microalbum inuria depends of the initial UAE values and the kind of antihypertensive t reatment. ACEI produced higher UAE reduction and lower derangement of the g lucose metabolism than BB.