Spot urinary albumin-creatinine ratio predicts left ventricular hypertrophy in young hypertensive African-American men

Hypertensive patients with target organ damage are at increased cardiovascu lar risk, and should be treated most aggressively. The association between urinary albumin excretion and left ventricular hypertrophy (LVH) in prior s tudies is inconsistent, and has not been described using a single, random s pot urine specimen. Therefore, we evaluated the association between the uri nary albumin creatinine ratio (ACR) and left ventricular (LV) mass and also tested the hypothesis that a simple random, single-void urine ACR would id entify high risk young, hypertensive, African-American men. We measured ech ocardiographic LV mass and a random spot urinary ACR in 109 untreated, hype rtensive, young, inner city, African-American men. The mean age was 41 +/- 6 years and the mean blood pressure (BP) was 157 +/- 19/107 +/- 13 mm Hg. M icroalbuminuria (ACR 30 to 300 mg/g) was present in 22% of subjects. The AC R is higher in the men with LVH than in the men without LVH (P < .05). Incr eased ACR is a predictor of increased LV mass index (P < .003) using multip le linear regression. An ACR >30 mg/g has a sensitivity of 33% and a specif icity of 82% for the diagnosis of echocardiographic LVH. In conclusion, ele vated random spot ACR is a marker of increased LV mass, independent of BP, in young urban African-American men with hypertension, and may help to dete rmine the aggressiveness of antihypertensive therapy in this high-risk grou p. Am J Hypertens 2000;13:1168-1172 (C) 2000 American Journal of Hypertensi on, Ltd.