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Utility of urinary albumin excretion as an index for stratifying the residual cardiovascular risk in patients undergoing antihypertensive agents treatment
- Source :
- Journal of Hypertension. 39:2431-2438
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background Patients treated with antihypertensive medication, even those with well controlled blood pressure (BP), are at higher risk for the development of atherosclerotic cardiovascular disease (ASCVD) in comparison to nonhypertensive individuals with optimal risk levels. We hypothesized that this residual risk could be stratified based on urinary albumin excretion (UAE). Methods A total of 13 082 middle-aged and older individuals with SBP/DBP of less than 160/100 mmHg and urinary albumin-to-creatinine ratios (UACRs) of less than 300 mg/g, and who were free from ASCVD events, were followed to investigate the incidence of ASCVD. The baseline BP was classified into four categories: normal BP (BP1), high normal BP (BP2), elevated BP (BP3), and grade 1 hypertension (BP4) based on the 2019 Japanese Society of Hypertension guidelines. Results After an average 10.6 ± 2.6 years of follow-up, the multivariable hazard ratio for the development of ASCVD (n = 994) was already increased in medicated hypertensive patients with BP1 in comparison with untreated individuals with BP1; however, among medicated hypertensive patients, this risk was separated between the UAE groups, which were classified according to the median UACR (male, 15.4 mg/g; female, 19.0 mg/g). In medicated hypertensive patients with any category of BP1-BP3, the adjusted risk of the development of ASCVD in those with lower and higher UACRs was comparable to that observed in untreated individuals in the BP1 and BP4 categories, respectively. Conclusion In medicated patients with well controlled hypertension, UAE is useful for stratifying the residual risk of developing ASCVD in comparison to nonhypertensive individuals with optimal risk levels.
- Subjects :
- Male
medicine.medical_specialty
Urinary albumin
Physiology
Urinary system
Blood Pressure
Excretion
Risk Factors
Albumins
Internal medicine
Internal Medicine
Humans
Medicine
In patient
Antihypertensive Agents
Aged
business.industry
cardiovascular
Incidence (epidemiology)
Hazard ratio
Middle Aged
Residual risk
Blood pressure
Cardiovascular Diseases
Heart Disease Risk Factors
Hypertension
Female
Cardiology and Cardiovascular Medicine
business
urinary albumin
Subjects
Details
- ISSN :
- 14735598 and 02636352
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Journal of Hypertension
- Accession number :
- edsair.doi.dedup.....18e2c476530a8061c9e369fc7a57b8b8