Microalbuminuria as a marker of preclinical diastolic dysfunction in never-treated essential hypertensives

Anna M. Grandi, Rosa Santillo, Andrea Bertolini, Daniela Imperiale, Roberta Broggi, Sara Colombo, Elisabetta Selva, Alessandro Jessula, Luigina Guasti, Achille Venco

Research output: Contribution to journalArticle

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Abstract

Using 24-h ambulatory blood pressure (BP) monitoring and digitized M-mode echocardiography, we evaluated whether microalbuminuria is related to preclinical left ventricular (LV) diastolic dysfunction in hypertensive patients. We selected 87 never-treated hypertensive patients (mean 24-h BP > 140 and/or > 90 mm Hg); albuminuria was evaluated as mean value of 24-h urinary albumin excretion (UAE) from two 24-h urine collections. Microalbuminuria was found in 28 patients, classified as MA+ (UAE 30 to 300 mg/24 h); 59 patients had normal UAE (<30 mg/24 h) and were classified as MA-. The MA+ and MA- groups did not differ with regard to age, sex, body mass index, or 24-h heart rate, whereas 24-h, daytime, and nighttime systolic and diastolic BP were significantly higher in MA+ than in MA-. The LV mass index was greater in MA+, as was the prevalence of LV hypertrophy; peak shortening rate of LV diameter, index of systolic function, was normal in all, but was lower in MA+. Peak lengthening rate of LV diameter and peak thinning rate of posterior wall, indices of diastolic function, were lower in MA+ and the prevalence of diastolic dysfunction was higher in MA+. UAE was inversely correlated with both indices of LV diastolic function, also after correction for age, 24-h heart rate, 24-h BP, and LV mass. In conclusion, in never-treated hypertensive patients, microalbuminuria is not only associated with greater myocardial mass, but is also related with preclinical impairment of LV diastolic function. This relation, independent from increased BP or LV mass, strengthens the role of microalbuminuria as an early and reliable marker of preclinical cardiac involvement.

Original languageEnglish
Pages (from-to)644-648
Number of pages5
JournalAmerican Journal of Hypertension
Volume14
Issue number7 I
DOIs
Publication statusPublished - 2001

Fingerprint

Albumins
Blood Pressure
Left Ventricular Function
Heart Rate
Urine Specimen Collection
Ambulatory Blood Pressure Monitoring
Albuminuria
Left Ventricular Dysfunction
Left Ventricular Hypertrophy
Echocardiography
Body Mass Index

Keywords

  • Diastolic function
  • Microalbuminuria
  • Myocardial hypertrophy
  • Systolic function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Microalbuminuria as a marker of preclinical diastolic dysfunction in never-treated essential hypertensives. / Grandi, Anna M.; Santillo, Rosa; Bertolini, Andrea; Imperiale, Daniela; Broggi, Roberta; Colombo, Sara; Selva, Elisabetta; Jessula, Alessandro; Guasti, Luigina; Venco, Achille.

In: American Journal of Hypertension, Vol. 14, No. 7 I, 2001, p. 644-648.

Research output: Contribution to journalArticle

Grandi, AM, Santillo, R, Bertolini, A, Imperiale, D, Broggi, R, Colombo, S, Selva, E, Jessula, A, Guasti, L & Venco, A 2001, 'Microalbuminuria as a marker of preclinical diastolic dysfunction in never-treated essential hypertensives', American Journal of Hypertension, vol. 14, no. 7 I, pp. 644-648. https://doi.org/10.1016/S0895-7061(01)01305-X
Grandi, Anna M. ; Santillo, Rosa ; Bertolini, Andrea ; Imperiale, Daniela ; Broggi, Roberta ; Colombo, Sara ; Selva, Elisabetta ; Jessula, Alessandro ; Guasti, Luigina ; Venco, Achille. / Microalbuminuria as a marker of preclinical diastolic dysfunction in never-treated essential hypertensives. In: American Journal of Hypertension. 2001 ; Vol. 14, No. 7 I. pp. 644-648.
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AU - Colombo, Sara

AU - Selva, Elisabetta

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AB - Using 24-h ambulatory blood pressure (BP) monitoring and digitized M-mode echocardiography, we evaluated whether microalbuminuria is related to preclinical left ventricular (LV) diastolic dysfunction in hypertensive patients. We selected 87 never-treated hypertensive patients (mean 24-h BP > 140 and/or > 90 mm Hg); albuminuria was evaluated as mean value of 24-h urinary albumin excretion (UAE) from two 24-h urine collections. Microalbuminuria was found in 28 patients, classified as MA+ (UAE 30 to 300 mg/24 h); 59 patients had normal UAE (<30 mg/24 h) and were classified as MA-. The MA+ and MA- groups did not differ with regard to age, sex, body mass index, or 24-h heart rate, whereas 24-h, daytime, and nighttime systolic and diastolic BP were significantly higher in MA+ than in MA-. The LV mass index was greater in MA+, as was the prevalence of LV hypertrophy; peak shortening rate of LV diameter, index of systolic function, was normal in all, but was lower in MA+. Peak lengthening rate of LV diameter and peak thinning rate of posterior wall, indices of diastolic function, were lower in MA+ and the prevalence of diastolic dysfunction was higher in MA+. UAE was inversely correlated with both indices of LV diastolic function, also after correction for age, 24-h heart rate, 24-h BP, and LV mass. In conclusion, in never-treated hypertensive patients, microalbuminuria is not only associated with greater myocardial mass, but is also related with preclinical impairment of LV diastolic function. This relation, independent from increased BP or LV mass, strengthens the role of microalbuminuria as an early and reliable marker of preclinical cardiac involvement.

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