OBJECTIVE: The prognostic value of microalbuminuria is unsettled in resistant hypertension. The objective was to evaluate the importance of baseline and serial changes in albuminuria as predictors of cardiovascular morbidity and mortality in patients with resistant hypertension. METHODS: 531 resistant hypertensives had urinary albumin excretion rate (UAER) measured prospectively at baseline and at the 2nd year of follow-up. Primary endpoints were a composite of fatal and non-fatal cardiovascular events, all-cause and cardiovascular mortalities. Total strokes and coronary heart disease (CHD) events were secondary endpoints. Multiple Cox regression assessed the associations between UAER and endpoints. RESULTS: After a median follow-up of 4.9 years, 72 patients died, 42 from cardiovascular causes; 96 cardiovascular events occurred, 42 strokes and 47 CHD events. After adjustment for several cardiovascular risk factors, baseline UAER, either analyzed as a continuous variable or dichotomized at different cut-off values, was an independent predictor of the composite endpoint, all-cause and cardiovascular mortality, strokes and CHD events. Each 10-fold increase in UAER implied a significant 1.6, 1.5, 2.0, 1.5 and 1.6-fold higher risk, respectively, for each of the above endpoints. Serial changes in microalbuminuria status during follow-up tended to parallel changes in cardiovascular risk, regression of microalbuminuria was associated with a 27% lower risk and development with a 65% higher risk of having a cardiovascular event. CONCLUSIONS: Baseline albuminuria strongly predicts cardiovascular morbidity and mortality in resistant hypertensive patients and serial changes in microalbuminuria may translate into changes in risk. Microalbuminuria reduction may be a goal of anti-hypertensive treatment.
OBJECTIVE: The prognostic value of microalbuminuria is unsettled in resistant hypertension. The objective was to evaluate the importance of baseline and serial changes in albuminuria as predictors of cardiovascular morbidity and mortality in patients with resistant hypertension. METHODS: 531 resistant hypertensives had urinary albumin excretion rate (UAER) measured prospectively at baseline and at the 2nd year of follow-up. Primary endpoints were a composite of fatal and non-fatal cardiovascular events, all-cause and cardiovascular mortalities. Total strokes and coronary heart disease (CHD) events were secondary endpoints. Multiple Cox regression assessed the associations between UAER and endpoints. RESULTS: After a median follow-up of 4.9 years, 72 patients died, 42 from cardiovascular causes; 96 cardiovascular events occurred, 42 strokes and 47 CHD events. After adjustment for several cardiovascular risk factors, baseline UAER, either analyzed as a continuous variable or dichotomized at different cut-off values, was an independent predictor of the composite endpoint, all-cause and cardiovascular mortality, strokes and CHD events. Each 10-fold increase in UAER implied a significant 1.6, 1.5, 2.0, 1.5 and 1.6-fold higher risk, respectively, for each of the above endpoints. Serial changes in microalbuminuria status during follow-up tended to parallel changes in cardiovascular risk, regression of microalbuminuria was associated with a 27% lower risk and development with a 65% higher risk of having a cardiovascular event. CONCLUSIONS: Baseline albuminuria strongly predicts cardiovascular morbidity and mortality in resistant hypertensivepatients and serial changes in microalbuminuria may translate into changes in risk. Microalbuminuria reduction may be a goal of anti-hypertensive treatment.
Authors: Paula Moreira da Costa; Arthur Fernandes Cortez; Fabio de Souza; Gabriel de Souza Mares; Bruno Dussoni Moreira Dos Santos; Elizabeth Silaid Muxfeldt Journal: J Hum Hypertens Date: 2017-12-11 Impact factor: 3.012
Authors: G H Tofler; J Massaro; C J O'Donnell; P W F Wilson; R S Vasan; P A Sutherland; J B Meigs; D Levy; R B D'Agostino Journal: Thromb Res Date: 2016-02-03 Impact factor: 3.944
Authors: Juan Carlos Yugar-Toledo; Heitor Moreno Júnior; Miguel Gus; Guido Bernardo Aranha Rosito; Luiz César Nazário Scala; Elizabeth Silaid Muxfeldt; Alexandre Alessi; Andrea Araújo Brandão; Osni Moreira Filho; Audes Diógenes de Magalhães Feitosa; Oswaldo Passarelli Júnior; Dilma do Socorro Moraes de Souza; Celso Amodeo; Weimar Kunz Sebba Barroso; Marco Antônio Mota Gomes; Annelise Machado Gomes de Paiva; Eduardo Costa Duarte Barbosa; Roberto Dischinger Miranda; José Fernando Vilela-Martin; Wilson Nadruz Júnior; Cibele Isaac Saad Rodrigues; Luciano Ferreira Drager; Luiz Aparecido Bortolotto; Fernanda Marciano Consolim-Colombo; Márcio Gonçalves de Sousa; Flávio Antonio de Oliveira Borelli; Sérgio Emanuel Kaiser; Gil Fernando Salles; Maria de Fátima de Azevedo; Lucélia Batista Neves Cunha Magalhães; Rui Manoel Dos Santos Póvoa; Marcus Vinícius Bolívar Malachias; Armando da Rocha Nogueira; Paulo César Brandão Veiga Jardim; Thiago de Souza Veiga Jardim Journal: Arq Bras Cardiol Date: 2020 May-Jun Impact factor: 2.000
Authors: S-W Choi; M-K Kim; S W Han; S H Han; B K Lee; S U Lee; S-H Hur; S W Lim; K W Moon; S G Lee; S H Lee; S K Oh; J G Chea; S J Joo; M C Jo; K-S Hong; K-H Ryu Journal: J Hum Hypertens Date: 2013-08-29 Impact factor: 3.012