INCREASED URINARY ALBUMIN-EXCRETION RATE IN BENIGN ESSENTIAL HYPERTENSION

The daily urinary albumin-excretion rate was measured by a sensitive radioimmunoassay in eight normal subjects (average blood-pressure 126/83 mm. Hg), fourteen patients effectively treated for benign essential hypertension (average blood-pressure 143/89 mm. Hg), and eighteen untreated or insufficiently treated patients with benign essential hypertension (average blood-pressure 182/ 112 mm. Hg). None of the patients had albuminuria as judged by the 'Albustix' test. Albumin excretion was significantly increased in the insufficiently treated hypertensive group compared with the average normal value of 8.5 mg. per 24 hours. Five hypertensive patients had a distinctly increased albumin-excretion rate (mean 87 mg. per 24 hours), while a more moderate but still statistically significant increase was found in the remaining thirteen (mean 16.9mg. per 24 hours). The excretion-rate was normal in the patients treated effectively for hypertension (mean 7.8 mg. per 24 hours). Since the daily urinary 2–microglobulin-excretion rate was normal in the patients, indicating a normal tubular reabsorption of protein, it is concluded that transglomerular passage of albumin is increased in benign essential hyper-tension. This finding is compatible with the hypothesis that hypertensive extravasation of plasma- proteins, with subsequent deposition in the vascular wall-i.e., the concept of plasmatic vasculosis.