ELEVATED ALBUMIN EXCRETION IN NONMODULATING ESSENTIAL HYPERTENSIVE PATIENTS

Nonmodulating (NM) essential hypertensives are characterized by abnorm al renal and aldosterone responses to angiotensin II. Recently, II hyp erinsulinemia, hypercholesterolemia, and an increased prevalence of fa mily history of hypertension and myocardial infarction have been shown In NM hypertensives. Since an elevated urinary albumin excretion (UAE ) has been indicated as a negative prognostic marker for cardiovascula r diseases in essential hypertensives, we evaluated UAE in 50 male pat ients with mild to model-are essential hypertension (mean age 46.3 +/- 4.4 years), characterized as low renin CLR) (n = 14), modulating (M) (n = 20), and NM patients (n = 16) according to their renin profile an d ability to modulate the aldosterone response to a graded infusion el f angiotensin II. A group of 14 healthy male subjects (mean age 43.3 /- 3.9 years) served as control. Resulting data showed that NM had sig nificantly higher UAE (30.7 +/- 10.7 mu g/min) than controls (11.9 +/- 2.7 mu g/min, p < 0.0001), LR (22.1 +/- 8.4 mu g/min, p < 0.05), and M patients (19.7 +/- 6.6 mu g/ min, p = 0.0001) when all fed a 200-mmo l NaCl/day diet. On the contrary, differences in UAE disappeared when all subjects were on a low sodium regimen (10 mmol NaCl/day). Compared to LR and M patients, the NM ones also manifested higher low-density lipoprotein cholesterol levels (p < 0.05). Furthermore, these latter a nd UAE were positively correlated in NM patients (r = 0.579, p < 0.05) but not in the other subgroups. In conclusion, the current study demo nstrates elevated UAE in NM patients, suggesting the NM phenotype is c ombined to an increased cardiovascular risk.