Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica, WI

Objective: To investigate the relationship between blood pressure (BP), renal haemodynamics, anthropometric measures of obesity and urinary albumin excretion in hypertension and in a control group. Methods: Urinary albumin, BP and anthropometric measurements were carried out in patients attending the hypertension clinic of the University Hospital of the West Indies. A randomised stratified sample was then selected for renal haemodynamic assessment. A normoalbuminuric control group without hypertension or diabetes was also selected. Renal haemodynamics was assessed by measuring glomerular filtration rate using 51-chromium edetic acid (51Cr-EDTA) and renal blood flow using 125-iodohippurate (125-PAH). Results: Urinary albumin excretion was positively and significantly correlated with systolic pressure ( = 0.011, P < 0.003, r = 0.22), current body weight ( = 0.014, P < 0.04, r = 0.15) and the presence of diabetes ( = 0.9, P < 0.001, r = 0.3). in the sample selected for renal haemodynamics, patients with microalbuminuria had lower age-adjusted corrected renal blood flow (P < 0.006), effective renal plasma flow (P < 0.006) and higher filtration fraction (P < 0.006) when compared with patients without microalbuminuria. glomerular filtration rate in patients with microalbuminuria was not different from those without. urinary albumin excretion was positively and significantly correlated with systolic pressure ( = 0.016, P < 0.003, r = 0.40) and inversely related to corrected renal blood flow ( = -1.13, P < 0.0002, r = 0.46). waist:hip ratio was inversely related to corrected renal blood flow ( = -1.74, P < 0.02, adjusted r = 0.48). Conclusion: Systolic BP, diabetes and body weight were significant predictors of albuminuria in our patients. Microalbuminuria and body fat distribution as assessed by waist:hip ratio were important determinants of renal haemodynamics in this population.

microalbuminuria; renal function; waist:hip ratio; black; Jamaica; hypertension; diabetes mellitus