Abstract 3535: The Effect Of Smoking On Microalbuminouria In Hypertensive Patients
Background: Microabluminouria is a powerful predictor of cardiovascular events and is considered as target organ damage in patients with essential hypertension. Smoking is reported to be a determinant of persistent microabluminouria in diabetic patients. The purpose of the present study was to explore the effect of current smoking on microalbumin excretion in patients with essential hypertension.
Methods: The study comprised 9280 consecutive patients with essential hypertension, 3347 smokers, who visited our outpatient clinic from 1998 –2006. All patients underwent full clinical and laboratory screening evaluation, following a wash-out period at least for 15 days. In a 24hour urine collection microalbumin, albumin-creatinin ratio (ACR) and 24h creatinine clearance were measured. Smoking habits were assessed by means of a standard questionnaire.
Results: Smokers were younger (P=0.001), had higher diastolic blood pressure (P<0.001), greater microalbumin levels (30.1 vs 24.7 mg/lt, P<0.001), higher ACR (43.2 vs 36.3, P<0.001) and higher body mass index (28.51 vs 28.21, P=0.03) compared to non-smokers. The two groups had no differences in systolic blood pressure, renal hemodynamics, glucose levels and 24h creatinin clearance (P=NS). After multivariate analysis was performed, smoking remained a significant determinant of higher ACR and microalbumin levels (P<0.0001), independently of blood pressure, obesity.
Conclusion: Smoking is associated with greater microalbumin excretion in patients with essential hypertension. Thus smoking may pose an additional burden to renal function in these subjects.