Excessive urinary albumin levels are associated with future cardiovascularmortality in postmenopausal women

Background-Microalbuminuria is an early predictor of cardiovascular morbidi ty and mortality, in both diabetic patients and hypertensive patients. Litt le is known about the relation of microalbuminuria to cardiovascular diseas e in women of the general population. Methods and Results-We have studied the relation of urinary albumin levels to cardiovascular mortality in a cohere study of 12 239 postmenopausal wome n living in Utrecht, the Netherlands. The initial age was between 52 and 67 years. Women were followed on vital status between 1976 and 1995 (168 513 women-years). Albumin was determined in the urine of 561 cases and 557 cont rols. Data were analyzed by using a nested case-control design. The cardiov ascular mortality rate (95% CI) for women who were in the highest quintile of urinary albumin levels was 13.2/1000 years (8.1 to 20.9) compared with 2 .6/1000 years (2.3 to 3.1) in women without detectable urinary albumin. The age-adjusted rate ratio (95% CI) between these groups was 4.4 (2.6 to 7.6) . Conclusions-This is the first large cohort study that confirms a predictive role of urinary albumin for the risk of future cardiovascular mortality in dependent of hypertension and diabetes. Our findings support the hypothesis that microalbuminuria is a reflection of vascular damage and a marker of e arly arterial disease in women from the general population.