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A blood pressure independent association between glomerular albumin leakage and electrocardiographic left ventricular hypertrophy. The LIFE Study

Journal of Human Hypertension volume 16, pages 591–595 (2002)Cite this article

Abstract

In the Losartan Intervention For Endpoint reduction (LIFE) study left ventricular (LV) hypertrophy was associated with increased urine albumin/creatinine ratio (UACR) at baseline. To evaluate whether this association was due only to parallel blood pressure (BP)-induced changes we re-examined the patients after 1 year of antihypertensive treatment to investigate whether changes in LV hypertrophy and UACR were related independently of changes in BP. In 7142 hypertensive patients included in the LIFE study, we measured UACR, LV hypertrophy by electrocardiography, plasma glucose and BP after 2 weeks of placebo treatment and again after 1 year of antihypertensive treatment with either an atenolol or a losartan based regime. At baseline and still after 1 year of treatment logUACR (R = 0.28, P < 0.001) was still correlated to LV hypertrophy (β = 0.05) assessed by ECG independently of systolic BP (β = 0.16), plasma glucose (β = 0.19) and age (β = 0.08). Change in logUACR (R = 0.19, P < 0.001) during treatment was correlated to change in LV hypertrophy (β = 0.10) independently of reduction in systolic BP (β = 0.13) and change in plasma glucose (β = 0.06). After 1 year of antihypertensive treatment UACR was still related to LV hypertrophy independently of systolic BP, and the reduction in UACR during that first year of treatment was related to regression of LV hypertrophy independently of reduction in systolic BP. This suggests that the relationship between LV hypertrophy and glomerular albumin leakage is not just due to parallel BP-induced changes. As glomerular albumin leakage may represent generalised vascular damage we hypothesise a vascular relationship between cardiac and glomerular damage.

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Acknowledgements

The study was funded in part by grants from Merck & Co, Inc, West Point, PA, and King Christian the Tenth's Foundation, Copenhagen, Denmark.

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Authors and Affiliations

  1. Copenhagen County University Hospital, Glostrup, Denmark

    M H Olsen, K Wachtell & H Ibsen

  2. Steno Diabetes Center, Copenhagen, Denmark

    K Borch-Johnsen

  3. The Weill Medical College of Cornell University, NY, USA

    P M Okin & R B Devereux

  4. Ullevaal University Hospital, Oslo, Norway

    S E Kjeldsen

  5. Sahlgrenska University Hospital-Östra, Göteborg, Sweden

    B Dahlöf

Authors
  1. M H Olsen
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  2. K Wachtell
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  3. K Borch-Johnsen
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  4. P M Okin
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  6. B Dahlöf
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  7. R B Devereux
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  8. H Ibsen
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Correspondence to M H Olsen.

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Olsen, M., Wachtell, K., Borch-Johnsen, K. et al. A blood pressure independent association between glomerular albumin leakage and electrocardiographic left ventricular hypertrophy. The LIFE Study. J Hum Hypertens 16, 591–595 (2002). https://doi.org/10.1038/sj.jhh.1001450

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  • DOI: https://doi.org/10.1038/sj.jhh.1001450

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