Abstract 320: Urinary Albumin Excretion at Follow Up Predicts Cardiovascular Outcomes in Subjects With Resistant Hypertension
Renal function and albuminuria predict CV disease in general population, but their predictive value in resistant hypertension (RH) is rather unknown.
Aim: to determine the ability of renal parameters to predict adverse CV outcomes in RH patients.
Methods: One hundred thirty-three (59% males, aged 61yr) RH pts. (BP ≥140/90 mmHg despite treated with ≥3 antihypertensive drugs) were evaluated. Mean follow-up: 88±5 months. Primary composite end-point: first occurrence of a CV event (nonfatal myocardial infarction, nonfatal stroke, new-onset heart failure, coronary or peripheral by-pass) or CV death. Renal function was assessed by serum creatinine, creatinine clearance (CrCL) and urine albumin/creatinine ratio (UACR). Microalbuminuria (MAB) was defined as UACR >30mg/g.
Results: Twenty-two subjects (16.5%) reached the primary end-point. After adjustments for previous CV disease, systolic BP both at baseline and during follow-up and CrCl, high UACR during follow-up was significantly associated with a worse CV outcome (Table). More patients who had a CV event developed MAB at follow-up (28% vs. 6%), whereas the proportion with MAB regression in this group was lower (11% vs. 19%); p=0.005. Although renal function was also associated with outcome in unadjusted analyses, the significance was lost after baseline risk and BP adjustment.
Conclusion: in patients with resistant hypertension, microalbuminuria at follow-up but not at baseline independently predicts CV outcomes.
* adjusted for SBP both at baseline and during follow-up and previous CV disease
** adjusted for the aforementioned confounders plus CrCl both at baseline and at follow-up; UACR tested after log transformation.
- © 2012 by American Heart Association, Inc.