Left ventricular mass assessed by electrocardiography and albumin excretion rate as a continuum in untreated essential hypertension

Objective To study an association between albumin excretion rate and left v entricular mass (LVM) determined by electrocardiogram (ECG)-based criteria, and with respect to ambulatory blood pressure, in patients with newly diag nosed and never-treated essential hypertension. Methods We measured 24 h ambulatory blood pressure, albumin excretion rate and LVM in 74 patients with newly diagnosed (within the past year) and neve r-treated essential hypertension, who were admitted to the hypertension cli nic (Ulleval University Hospital). Albumin excretion rate was evaluated by determination of the albumin: creatinine ratio in the first-voided morning urine sample. LVM was assessed by ECG using Cornell voltage-QRS duration pr oduct and Sokolow-Lyon criteria. Results Albumin excretion rate was significantly related to ambulatory bloo d pressure. There was a weak but significant negative correlation between t he decrease in diastolic blood pressure during the night and the rate of ex cretion of albumin. The patients classified as dippers had a significantly lower albumin excretion rate compared with the non-dippers (1.36 +/- 0.83 c ompared with 1.68 +/- 0.87 mg/mmol; P = 0.03). LVM was found to be signific antly related to ambulatory blood pressure. A weak relationship was observe d between albumin excretion rate and LVM as evaluated by Cornell criterion (r = 0.23, P = 0.045). When only normoalbuminuric patients were included (i .e. four patients with microalbuminuria were excluded), the relationship wa s stronger (r = 0.36, P = 0.002). Conclusions The present findings show a continuous relationship between alb umin excretion rate, LVM and ambulatory blood pressure in newly diagnosed p atients with essential hypertension, and suggest the occurrence of early ef fects on target organs (kidneys and heart). These associations were observe d using easily applicable methods such as ECG monitoring and determination of the albumin: creatinine ratio in morning urine samples. (C) 2001 Lippinc ott Williams & Wilkins.