STUDY OF MICROALBUMINURIA IN ESSENTIAL HYPERTENSION

Abstract

BACKGROUND : Essential hypertension usually clusters with other cardiovascular risk factors such as age ,overweight, diabetes, insulin resistance and dyslipidemia. Subtle target organ damage such as left ventricular hypertrophy, microalbuminuria ,acute coronary syndrome, stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension ishigh in India, the relationship between MA and target organ damage in hypertension is not well studied. We aim at detecting MA in essential HTN & its relation to severity of HTN, duration of HTN, body mass index, age & TOD such as HTN retinopathy & ACS. MATERIALS AND METHODS: The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.U’s Shri B.M.Patil Medical College, Bijapur, from October 2008 to July 2010. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. OBSERVATION & RESULTS: The prevalence of MA in this study was found to be 63 % . In that 42% were male & 21% were female.We found out a significant association between MA & the duration xii of hypertension (p = 0.036) & (OR =0.438) . Longer the duration of hypertension, more possibility of microalbumin in urine . Also there was a significant association between severity of hypertension & MA ( p=0.045) &(OR=0.093). MA was positive in 50 (79.4%) patients out of 63 ,whose blood pressure was >160/100 mm Hg . We also found out a significant association between MA & the grades of hypertensive retinopathy (p =0.011) (highly significant). And we also found out a significant association between microalbuminuria & acute coronary syndrome ( p = 0.041) (OR =2.805). Gender & BMI did not pose high risk for MA in this study. CONCLUSION: The prevalence of MA in essential hypertension is high in this part of the community & MA will increase the risk of developing target organ damage. Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.