Blood pressure control is similar in treated hypertensive patients with optimal or with high-normal albuminuria

Abstract

Background: Although elevated urinary albumin excretion (UAE) is associated with cardiovascular prognosis and high blood pressure (BP), it is unknown whether differences in BP control could also exist between patients with different grades of UAE, even in the normal range. We sought to explore the association between different levels of UAE and BP control in treated hypertensive patients.

Methods: A cohort of 1,200 treated hypertensive patients was evaluated. Clinical data, including 2 office BP measurements and UAE averaged from 2 samples, were recorded. Albuminuria was categorized into 4 groups: G0 (UAE <10mg/g), G1 (UAE 10-29 mg/g), G2 (UAE 30-299 mg/g), and G3 (UAE ≥300 mg/g).

Results: Forty-three percent of patients had systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg. Median UAE was significantly higher (20.3 vs. 11.7 mg/g; P < 0.001) in these patients than in controlled hypertensive patients (BP<140/90 mm Hg). When UAE was categorized into the 4 groups, there were differences in BP control among groups (P < 0.001).The proportion of noncontrolled patients in G2 (52.3%) was significantly higher than in G0 (36.8%) and G1 (41.5%) (P < 0.01 and P < 0.05, respectively). Importantly, no significant differences were observed between G0 and G1 (P = 0.18) or between G2 and G3 (P = 0.48). With G0 as the reference group, the odds ratio of lack of BP control for the G2 group after adjustment for confounders was 1.40 (95% confidence interval =1.16-1.68; P < 0.001).

Conclusions: Lack of BP control is more prevalent among patients with microalbuminuria than in patients with normoalbuminuria. No significant difference was seen between patients with optimal or high-normal UAE.

Keywords: blood pressure; blood pressure control; high-normal albuminuria; hypertension; low-grade albuminuria; microalbuminuria; uncontrolled hypertension..