Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
« Previous Article | Table of Contents | Next Article »
Circulation. 2005;111:1370-1376
Published online before print February 28, 2005, doi: 10.1161/01.CIR.0000158434.69180.2D
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
111/11/1370    most recent
01.CIR.0000158434.69180.2Dv1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wang, T. J.
Right arrow Articles by Vasan, R. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wang, T. J.
Right arrow Articles by Vasan, R. S.
Related Collections
Right arrow Clinical Studies
Right arrow Epidemiology

(Circulation. 2005;111:1370-1376.)
© 2005 American Heart Association, Inc.

Hypertension

Low-Grade Albuminuria and the Risks of Hypertension and Blood Pressure Progression

Thomas J. Wang, MD; Jane C. Evans, DSc; James B. Meigs, MD, MPH; Nader Rifai, PhD; Caroline S. Fox, MD, MPH; Ralph B. D’Agostino, PhD; Daniel Levy, MD; Ramachandran S. Vasan, MD

From the Framingham Heart Study, Framingham, Mass (T.J.W., J.C.E., C.S.F., R.B.D., D.L., R.S.V.); Cardiology Division (T.J.W.), General Medicine Division (J.B.M.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Center for Cardiovascular Disease Prevention (N.R.), Department of Endocrinology, Hypertension, and Diabetes (C.S.F.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Mathematics (R.B.D.), Statistics and Consulting Unit, Boston University, Boston, Mass; the National Heart, Lung, & Blood Institute (C.S.F., D.L.), Bethesda, Md; and Preventive Medicine and Cardiology Sections (R.S.V.), Boston Medical Center, Boston University School of Medicine, Boston, Mass.

Correspondence to Ramachandran S. Vasan, MD, Framingham Heart Study, 73 Mt. Wayte Ave, #2, Framingham, MA 01702-5827. E-mail vasan{at}bu.edu

Received August 14, 2004; revision received November 25, 2004; accepted December 20, 2004.

Background— It has been postulated that glomerular hyperfiltration and endothelial dysfunction are early features of essential hypertension that may antedate blood pressure elevation. Microalbuminuria, a marker of glomerular hyperfiltration and endothelial dysfunction, has been described in individuals with established hypertension, but its role as a biomarker of preclinical stages of this disease has not been investigated prospectively.

Methods and Results— We examined the association between urinary albumin excretion and the risks of hypertension and blood pressure progression in 1499 nonhypertensive individuals (58% women) without diabetes. During a mean follow-up of 2.9 years, 230 participants (15%) developed hypertension and 499 (33%) progressed to a higher blood pressure category (defined by the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). In multivariable logistic regressions that adjusted for known risk factors, the urine albumin-creatinine ratio (UACR) was a significant predictor of incident hypertension (adjusted OR 1.20, 95% CI 1.01 to 1.44, per 1-SD increment in log UACR). Compared with those in the lowest UACR quartile, participants in the highest quartile (men: >6.66 mg/g; women: >15.24 mg/g) had an {approx}2-fold risk of developing hypertension (adjusted OR 1.93, P=0.006) and 1.5-fold risk of blood pressure progression (adjusted OR 1.45, P=0.03).

Conclusions— Urinary albumin excretion predicts blood pressure progression in nondiabetic, nonhypertensive individuals incrementally over established risk factors and at levels well below the conventional threshold for microalbuminuria. UACR may be a useful biomarker for identifying individuals most likely to develop hypertension.


Key Words: blood pressure • risk factors • hypertension • epidemiology




This article has been cited by other articles:


Home page
 J. Am. Soc. Nephrol.Home page
J. P. Forman, N. D.L. Fisher, E. L. Schopick, and G. C. Curhan
Higher Levels of Albuminuria within the Normal Range Predict Incident Hypertension
J. Am. Soc. Nephrol., October 1, 2008; 19(10): 1983 - 1988.
[Abstract] [Full Text] [PDF]

Home page
 HypertensionHome page
N. Dhaun, J. Goddard, D. E. Kohan, D. M. Pollock, E. L. Schiffrin, and D. J. Webb
Role of Endothelin-1 in Clinical Hypertension: 20 Years On
Hypertension, September 1, 2008; 52(3): 452 - 459.
[Full Text] [PDF]

Home page
 HypertensionHome page
W. Lieb, M. J. Pencina, T. J. Wang, M. G. Larson, K. J. Lanier, E. J. Benjamin, D. Levy, G. H. Tofler, J. B. Meigs, C. Newton-Cheh, et al.
Association of Parental Hypertension With Concentrations of Select Biomarkers in Nonhypertensive Offspring
Hypertension, August 1, 2008; 52(2): 381 - 386.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
A. Mimran and G. du Cailar
Dietary sodium: the dark horse amongst cardiovascular and renal risk factors
Nephrol. Dial. Transplant., July 1, 2008; 23(7): 2138 - 2141.
[Full Text] [PDF]


Circulation Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search
Copyright © 2005 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.