Abstract
This Practice Point commentary discusses a study by Boersma et al. that aimed to investigate whether the efficacy of blood-pressure-lowering agents depends on a patient's level of urinary albumin excretion before initiation of treatment. Boersma et al. reported that the higher baseline albuminuria is in hypertension, the better the relative and absolute risk reductions for cardiovascular events with antihypertensive drugs. Their data also suggested that the cardiovascular protective effect of agents that interfere with the renin–angiotensin–aldosterone system in patients with elevated urinary albumin excretion is better than that of other blood-pressure-lowering agents. Here, the importance of measuring urinary albumin excretion in clinical practice to improve the cardiovascular prognosis of hypertensive patients will be discussed. The many potential pitfalls of this observational study are highlighted and the need for well-designed, large, randomized trials in the area is emphasized.
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References
Boersma C et al. (2008) Baseline albuminuria predicts the efficacy of blood pressure-lowering drugs in preventing cardiovascular events. Br J Clin Pharmacol 65: 723–732
Basi S et al. (2008) Microalbuminuria in type 2 diabetes and hypertension: a marker, treatment target, or innocent bystander? Diabetes Care 31 (Suppl 2): S194–S201
Atkins RC et al. (2005) Proteinuria reduction and progression to renal failure in patients with type 2 diabetes mellitus and overt nephropathy. Am J Kidney Dis 45: 281–287
de Zeeuw D et al. (2004) Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int 65: 2309–2320
Lewis EJ et al. (2001) Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 345: 851–860
Asselbergs FW et al. (2004) Effects of fosinopril and pravastatin on cardiovascular events in subjects with microalbuminuria. Circulation 110: 2809–2816
Ibsen H et al. (2005) Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients: losartan intervention for endpoint reduction in hypertension study. Hypertension 45: 198–202
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Palatini, P. Assessment of urinary albumin excretion might improve cardiovascular outcome in patients with hypertension. Nat Rev Nephrol 4, 414–415 (2008). https://doi.org/10.1038/ncpneph0861
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DOI: https://doi.org/10.1038/ncpneph0861
