Dissociation between microalbuminuria and common carotid thickness in essential hypertensive men

Background: The reasons why microalbuminuria (albuminuria greater than or e qual to 15 mug/min), an expression of a renal microcirculatory abnormality, predicts cardiovascular disease in essential hypertension are unsettled, T o test the hypothesis that microalbuminuria represents a marker of subclini cal atherosclerosis, we evaluated its association with common carotid arter y (CCA) intima media thickness (IMT), a measure of preclinical atherosclero sis and an independent predictor of cardiac and cerebrovascular events, in uncomplicated essential hypertensive individuals, Materials and methods: Albuminuria, ultrasonographic CCA IMT (the mean of s ix bilateral far wall measurements within 1.5 cm proximally to the flow div ider), brachial blood pressure (BP), smoking habits and lipids were evaluat ed in 136 stage 1-3 untreated essential hypertensive men free of cardiovasc ular disease. Results: CCA IMT did not differ between normo- (n = 99) and m icroalbuminuric (n = 37) patients, The correlation between CCA IMT and albu minuria was not significant, and the prevalence of microalbuminuria across IMT quartiles was not different, Microalbuminuric patients showed higher sy stolic BP and that parameter was the only independent correlate in a multiv ariate logistic regression model including also age, CCA IMT, diastolic BP, lipids and smoking habits as independent variables and microalbuminuria as the dependent one, Conclusion. This cross-sectional study in hypertensive subjects free of car diovascular disease has shown a dissociation between microalbuminuria and C CA IMT, a surrogate measure of subclinical atherosclerosis, and a parameter linearly related to cardiovascular events. The data do not support the the ory of microalbuminuria as a surrogate measure of subclinical atheroscleros is, while confirming the importance of systolic BP levels as an independent correlate of increased albuminuria in essential hypertension.