Association Between Microalbuminuria and Pulse Pressure Among Patients with Isolated Systolic and Diastolic Hypertension
Journal Title: E Journal of Cardiovascular Medicine - Year 2021, Vol 9, Issue 1
Abstract
Objectives: The aim of this study is to examine the prevalence and predictors of microalbuminuria and to investigate the association between microalbuminuria and pulse pressure among patients with isolated systolic and diastolic hypertension (DH). Materials and Methods: In this cross-sectional study, patients with DH and isolated systolic hypertension (ISH) were included. Data including patient age, sex, duration of hypertension (HT), comorbidities, and drugs were recorded. Blood analysis of serum total cholesterol, high D-density lipoprotein (HDL) cholesterol, triglyceride, urea, creatinine, and fasting blood glucose, urinalysis, electrocardiography (ECG), transthoracic echocardiography, exercise stress test (EST), and coronary angiography (if the patient had a positive EST result) were performed. Results: Overall, we included 183 patients (58.5% female) with HT. The patients with ISH had significantly higher pulse pressure, left ventricular (LV) mass, and LV mass index, but had a shorter duration of HT and lower diastolic blood pressure than those with DH. All patients were in sinus rhythm, and there were no ischemic ECG changes. Fifty-nine (32.2%) patients had microalbuminuria (MA) (≥20 μg/min). LV mass, left atrial diameter, E/A ratio, systolic blood pressure (SBP), pulse pressure, and frequency of LVH were significantly higher in patients with MA than in patients without MA. The prevalence of angiographically proven atherosclerotic heart disease was similar in patients with and without microalbuminuria. Multivariate binary logistic regression analysis revealed that only systolic pressure and left atrial diameter were independent associates of microalbuminuria. Each 1 mmHg increase in SBP was associated with a 3% increase in the risk of having microalbuminuria (p=0.04). In addition, each 1 mm increase in the diameter of the left atrium increased the risk of having microalbuminuria by 20% (p=0.02). Conclusion: This study demonstrated that microalbuminuria in hypertensive patients was independently associated with left atrial size and systolic blood pressure, but not with pulse pressure.
Authors and Affiliations
Şenol Coşkun, Jale Cordan, Ertuğrul Mehmetoğlu, Saim Sağ, Dilek Yeşilbursa, Osman Akın Serdar, Sümeyye Güllülü, Ali Aydınlar
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