Microproteinuria and long-term prognosis with respect to renal function and survival in normotensive and hypertensive women - A 24-year follow-up of a representative population sample of women in Gothenburg, Sweden

Objective: This study aimed to assess albuminuria and subclinical proteinur ia. their association with hypertension and their role as predictors of hyp ertension, impaired renal function and mortality.;Material and Methods: A b aseline population study comprising 1462 women in five different age groups in Gothenburg, Sweden. was carried out in 1968-69. Comprehensive clinical examinations and laboratory tests were performed. including blood pressure measurement and an Albustix test. A systematic subsample of women additiona lly collected a 24 h urine sample for quantitative protein analysis. Values of urinary protein (u-protein) excretion between XO and 300 mg/24 h were d efined as microproteinuria. The results described in this paper are based o n a 24-year follow-up. Results: The baseline Albustix test was positive in 6.8% of 1458 women, from whom a urine sample was obtained. Of 741 baseline urine collections for u-protein excretion, 16.9% were in the microproteinur ic range (80-300 mg/24 h), 1.1% in the macroproteinuric range (>300 mg/24 h ) and 82.1% in the normoproteinuric range (< 80 mg/24 h). Hypertension was more common in Albustix-positive women than in those with negative Albustix , and hypertension was also more prevalent in women with microproteinuria t han in women with normoproteinuria. Neither positive Albustix nor microprot einuria was related to later renal impairment. Hypertension was associated with increased mortality in both Albustix-positive and Albustix-negative: w omen, and in women with both normoproteinuria and microproteinuria at basel ine. The mortality ratio during the follow-up period was, however, not sign ificantly influenced by positive Albustix or by microproteinuria at baselin e, in either hypertensive or non-hypertensive women. Conclusions. This stud y demonstrated that both a positive Albustix test and microproteinuria were associated with hypertension. Hypertension at baseline increased the risk for death during the follow-up period, while neither albuminuria, defined a s a positive Albustix test, nor microproteinuria was associated with an imp aired long-term prognosis with respect to renal function or survival in thi s cohort of Swedish middle-aged women during 24 years of follow-up. Micropr oteinuria in otherwise healthy normotensive or hypertensive women does not appear to impair the long-term prognosis.