This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pedrinelli, R. Articles by Mariani, M. Search for Related Content PubMed PubMed Citation Articles by Pedrinelli, R. Articles by Mariani, M. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information High Blood Pressure Related Collections Risk Factors Other hypertension Other etiology

(Hypertension. 1999;34:491-495.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Microalbuminuria and Transcapillary Albumin Leakage in Essential Hypertension

Roberto Pedrinelli; Giuseppe Penno; Giulia Dell'Omo; Simona Bandinelli; Davide Giorgi; Vitantonio Di Bello; Renzo Navalesi; Mario Mariani

From the Dipartimento Cardiotoracico (R.P., G.D., M.M.), Diabetologia (G.P., S.B., R.N.), Medicina Interna (D.G., V.D.), Universita' di Pisa, Italy.

Abstract—Microalbuminuria (an increased urinary albumin excretion that is not detectable by the usual dipstick methods for macroproteinuria) predicts cardiovascular events in essential hypertensive patients. A possible reason for this behavior is that albumin leaks through exaggeratedly permeant glomeruli exposed to the damaging impact of subclinical atherogenesis. To evaluate this possibility, the transcapillary escape rate of albumin (TER_alb, the 1-hour decline rate of intravenous ¹²⁵I-albumin), a parameter that estimates the integrity of systemic capillary permeability, albuminuria, blood pressure, echocardiographic left ventricular mass, lipids, and body mass index were measured in 73 uncomplicated, glucose-tolerant men with essential hypertension and normal renal function; 53 were normoalbuminuric, and 20 were microalbuminuric. Twenty-one normotensive age-matched male subjects were the controls. TER_alb was higher in hypertensives, a behavior explained in part by a positive correlation with blood pressure values, although body mass index, lipids, and left ventricular mass showed no association. Transcapillary albumin leakage values did not differ between normoalbuminuric and microalbuminuric patients and were unrelated to albuminuria. Blood pressure, particularly systolic, and cardiac mass were higher in microalbuminuric patients in whom albuminuria correlated with both cardiovascular variables and indicated the influence of the hemodynamic load on urinary albumin levels. Thus, TER_alb, a parameter influenced by the permeability surface area product for macromolecules and the filtration power across the vascular wall, is altered in essential hypertensives. However, this abnormality is dissociated from the amount of albuminuria, which is contrary to the hypothesis that a higher albumin excretion reflects a greater degree of systemic microvascular damage in essential hypertension.

Key Words: albuminuria • hypertension, essential • cardiac mass • blood pressure • capillary permeability

This article has been cited by other articles:

				A. J.M. Rennings, P. Smits, M. W. Stewart, and C. J. Tack Fluid retention and vascular effects of rosiglitazone in obese, insulin-resistant, nondiabetic subjects. Diabetes Care, March 1, 2006; 29(3): 581 - 587. [Abstract] [Full Text] [PDF]

				H. L. Hillege, V. Fidler, G. F.H. Diercks, W. H. van Gilst, D. de Zeeuw, D. J. van Veldhuisen, R. O.B. Gans, W. M.T. Janssen, D. E. Grobbee, P. E. de Jong, et al. Urinary Albumin Excretion Predicts Cardiovascular and Noncardiovascular Mortality in General Population Circulation, October 1, 2002; 106(14): 1777 - 1782. [Abstract] [Full Text] [PDF]

				R. Pedrinelli, G. Dell'Omo, G. Penno, and M. Mariani Non-diabetic microalbuminuria, endothelial dysfunction and cardiovascular disease Vascular Medicine, November 1, 2001; 6(4): 257 - 264. [Abstract] [PDF]

				L. DeMaio, Y. S. Chang, T. W. Gardner, J. M. Tarbell, and D. A. Antonetti Shear stress regulates occludin content and phosphorylation Am J Physiol Heart Circ Physiol, July 1, 2001; 281(1): H105 - H113. [Abstract] [Full Text] [PDF]