MICROALBUNURIA IN HYPERTENSIVE PATIENTS ATTENDING GENERAL MEDICINE OPD AT PRAKASH INSTITUTE OF MEDICAL SCIENCE & RESEARCH URUN-ISLAMPUR, MAHARASHTRA, INDIA.
Abstract
ABSTRACT:
INTRODUCTION: Hypertension is a major public health problem all over the world and in India the prevalence of hypertension is around 25% in urban and 10-15% in rural, adult population while in the West it is 30%. Albumin is recognized as the earliest sign of vascular damage in both the kidney and the heart and albuminuria and its association with kidney disease. Proteinuria and microalbuminuria are independent predictors of cardiovascular morbidity and mortality in patients with hypertension. Kidney disease is linked to heart disease and the presence of microalbuminuria which can be defined as urinary albumin excretion of 30 - 300 mg / day, or 20-200 µg/min is a predictor of worse outcomes for both kidney and heart patients. Microalbuminuria does not directly cause cardiovascular diseases but it serves as a marker for identifying those who may be at increased risk of cardiovascular episodes. Albuminuria might reflect a general vascular dysfunction and leakage of albumin and other plasma macromolecules like low density lipoproteins which lead to inflammatory responses and start the atherosclerosis process.
MATERIAL AND METHODS: This is an observational, cross-sectional study done in hypertensive patients. Blood pressure monitoring was carried out according to the WHO guidelines. The values reported were the average of three consecutive measurements taken over a 15-minute period. All routine biochemical tests and microalbuminuria tests were performed by the laboratory. All patients determined to have microalbuminuria who matched the inclusion criteria were enrolled for a 1-year follow-up. Statistical analysis was performed by using standard methods to calculate rates and proportions. RESULTS: A total of 157 patients were included in the study. Out of which 96 (61%) were male and 61 (39%) were female. Retinopathy was observed in 21 (13%) cases and Left ventricular hypertrophy was seen in 67 (43%) patients. Microalbuminuria was observed in 92 (59%) cases. Systolic Blood pressure and diastolic blood pressure in microalbuminuric cases was 163.5±19.2, and 101.6±8.9 respectively, while in normal patients it was 144.3±17.2 and 85.4±11.2. There was significant difference observed in microalbuminuric and normal cases in terms of serum urea, serum creatinine, serum uric acid and serum cholesterol. Urinary albumin excretion was significantly higher in microalbuminuric cases as compared to normal patients.
CONCLUSION: The prevalence of microalbuminuria among patients with essential hypertension was 59% and was associated with higher blood pressure values. . Prevalence of microalbuminuria in hypertensive patients suggests that screening for microalbuminuria is essential for intervention and prevention of further complications.
