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Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults

Journal of Human Hypertension volume 21, pages 231–238 (2007)Cite this article

Abstract

We investigated whether the urinary albumin/creatinine ratio (UACR), a measure of albuminuria, is associated with non-invasive measures of arterial function in hypertensive adults without known coronary heart disease (CHD) or stroke. UACR was measured in the first voided morning urine sample in 469 non-Hispanic white hypertensive individuals (mean age 62.2±9.8 years, 41% men) belonging to hypertensive sibships. High-resolution ultrasonography of the brachial artery was used to assess flow-mediated dilatation (FMD) – an endothelium-dependent response – and nitroglycerin-mediated dilatation (NMD) – an endothelium-independent response. Because of skewed distribution, UACR was log transformed after addition of 0.1. The association of log (UACR+0.1) with FMD and NMD, before and after adjustment for CHD risk factors, serum creatinine, and hypertension medication and statin use was assessed using linear regression analyses. In univariable analyses, variables associated with lower FMD were greater age, male sex, history of smoking, lower high-density lipoprotein (HDL) cholesterol, higher serum creatinine and higher log (UACR+0.1); variables associated with lower NMD were greater age, male sex, higher systolic blood pressure, lower HDL cholesterol, higher serum creatinine and higher log (UACR+0.1). In separate stepwise multivariable regression analyses that adjusted for conventional CHD risk factors, serum creatinine and hypertension medication and statin use, higher log (UACR+0.1) was associated with lower brachial artery FMD (P=0.035) and NMD (P=0.0002). These findings highlight the association of increased urinary albumin excretion with impaired vascular reactivity in hypertensive individuals.

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Acknowledgements

This work was supported by a Mentored Patient-Oriented Research Career Development Award (K-23, RR17720) from the National Center for Research Resources to IJK, by grants HL54464 and M01 RR00585 from the National Institutes of Health.

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Authors and Affiliations

  1. Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, MN, USA

    A R Malik, S Sultan & I J Kullo

  2. Division of Nephrology and Hypertension, Mayo Clinic and Foundation, Rochester, MN, USA

    S T Turner

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  1. A R Malik
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Correspondence to I J Kullo.

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Malik, A., Sultan, S., Turner, S. et al. Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults. J Hum Hypertens 21, 231–238 (2007). https://doi.org/10.1038/sj.jhh.1002143

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