As UACR values increase in the general population, so does the risk of left ventricular hypertrophy
Microalbuminuria is associated with left ventricular hypertrophy (LVH) in the general
population, new data suggest.
Correlations between albuminuria and LV mass and LVH previously have been reported, but most of these associations have been observed in selected groups, including patients with hypertension or diabetes. Mild renal dysfunction and LVH are both associated with increased risk of cardiovascular morbidity, but the correlation between these risk factors has not been well studied in the general population.
The urinary albumin-to-creatinine ratio (UACR) and LV geometry were determined in 1,187 randomly selected persons aged 25 to 74 years who underwent echocardiography as part of a large-scale, prospective study of cardiovascular risk factors in Augsburg, Germany. Heribert Schunkert, MD, and his group at Universitatsklinikum Schleswig-Holstein in Lübeck, Germany, used the Modification of Diet in Renal Disease study formula to estimate glomerular filtration rate (eGFR).
The prevalence of microalbuminuria (UACR 30-300 mg/g) and LVH were 6.2% and 17.9%, respectively. Mild or moderately impaired eGFR (less than 90 mL/min/1.73m2) was present in 21.1% of the study population base.
The likelihood of LVH increased with rising UACR values. The second and third UACR tertiles were associated with a 2.10 and 1.63 times higher risk of LVH compared with the first tertile (reference). Likewise, the risk of LVH increased with decreasing levels of eGFR.
The prevalence of LVH was significantly higher in persons with microalbuminuria than in those without it (32.4% vs. 16.9%). Systolic and diastolic BP were also significantly greater in those with microalbuminuria than in those without it. The association between UACR and LVH was stronger in men than in women, reported the authors.
“At the general population level, even low-grade albuminuria is as-sociated with LVH,” the researchers wrote in Nephrology Dialysis Transplantation (2006;21:2780-2787). “Thus, important end organ damage may be observed with increased prevalence at albumin excretion rates much lower than those currently considered to be at a pathological level.”