TITLE

Microalbuminuria: marker of vascular dysfunction, risk factor for cardiovascular disease

AUTHOR(S)
Garg, Jay P; Bakris, George L
PUB. DATE
February 2002
SOURCE
Vascular Medicine;2002, Vol. 7 Issue 1, p35
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Based on the data from large single and multi-center clinical trials, including the Heart Outcomes Prevention Evaluation (HOPE) study, it is clear that the presence of microalbuminuria is a signal from the kidney that cardiovascular risk is increased and that vascular responses are altered. This is exemplified by studies that have demonstrated that the compensatory vasodilation seen following relief from prolonged ischemia or infusion of vasodilators such as nitroglycerin is blunted in people with microalbuminuria. Thus, the presence of between 30 and 299 mg/day of albumin in the urine is associated with abnormal vascular responsiveness, which may be the result of more advanced atherosclerosis and not necessarily related to the presence of hypertension or renal disease. Agents known to reduce the rise in microalbuminuria or actually reduce the level of microalbuminuria, such as ACE inhibitors, angiotensin receptor blockers, HMG-CoA reductase inhibitors, beta blockers, non-dihydropyridine calcium channel blockers and diuretics, have all been shown to reduce cardiovascular mortality and in some cases preserve renal function. This article will present an overview of the data that support the assertion that a reduction in the rise of microalbuminuria is a significant consideration in the selection of agents to treat a given risk factor (cholesterol or blood pressure) to a recommended target goal. Achieving such a goal with agents that also impact microalbuminuria will provide for a more complete cardiovascular risk reduction.
ACCESSION #
6932253

 

Related Articles

  • Microalbuminuria: associations with height and sex in non-diabetic subjects. Gould, M.M.; Mohamed-Ali, V.; Goubet, S.A.; Yudkin, J.S.; Haines, A.P. // BMJ: British Medical Journal (International Edition);1/23/93, Vol. 306 Issue 6872, p240 

    Examines the association between microalbuminuria and cardiovascular risk factors in non-diabetic patients in London, England. Assessment of urinary albumin excretion rate; Association of systolic pressure with albumin excretion rate; Prevalence of the disease among male populations.

  • Independent Nurse: Albumin targets may not be low enough.  // GP: General Practitioner;8/26/2005, p11 

    The article reports that current thresholds for microalbuminuria may not be low enough to prevent cardiovascular diseases (CVD), according to U.S. researchers. They measured the association between urinary albumin excretion in 1,568 non-hypertensive, non-diabetic participants, aged an average 55...

  • Glomerular filtration rate <45 mI/min/ 1 .73 m� with microalbuminuria was associated with increased CV death. Hallan, S. // Evidence Based Medicine;Jun2008, Vol. 13 Issue 3, p89 

    STUDY QUESTION Does estimated glomerular filtration rate (ECFR) combined with urine albumin excretion predict cardiovascular (CV) death? STUDY DESIGN Design: cohort study (second Nord-Tr�ndelag Health Study [HUNT II]) with a median 8.3-year follow-up. Setting: Nord-Tr�ndelag County,...

  • A Critical Evaluation of Glycated Protein Parameters in Advanced Nephropathy: A Matter of Life or Death. Freedman, Barry I. // Diabetes Care;Jul2012, Vol. 35 Issue 7, p1621 

    In this article the author offers his views on the utility of hemoglobin A1C (A1C) in relation to cardiovascular disease and survival considering the use of other short-term markers in glycemia. He cites the importance of glycated albumin (GA) as it accurately reflects glycemic control in...

  • Inter-Relationships of microalbuminuria with the other surrogates of the atherosclerotic cardiovascular disease in hypertensive subjects. Tsioufis, Costas; Dimitriadis, Kyriakos; Antoniadis, Dimitris; Stefanadis, Christodoulos; Kallikazaros, Ioannis // American Journal of Hypertension;May2004, Vol. 17 Issue 5, p470 

    Clinical and epidemiologic data have demonstrated that microalbuminuria (MA) may legitimately be an integrated marker of cardiovascular risk in nondiabetic hypertensive patients. The relation of augmented urinary albumin excretion rate (UAER) with the other surrogates of the atherosclerotic...

  • Albumin Excretion Rate and Cardiovascular Risk. Strain, W. David; Chaturvedi, Nish; Bulpitt, Christopher J.; Rajkumar, Chakravarthi; Shore, Angela C. // Diabetes;Jun2005, Vol. 54 Issue 6, p1816 

    Elevated albumin excretion rate (AER) independently predicts total and cardiovascular mortality in a variety of conditions, although the exact mechanisms are unknown. Laser Doppler fluximetry was used to study associations with risk factors and renal damage (AER calculated from a timed overnight...

  • The Association of the Metabolic Syndrome with PAI-1 and t-PA Levels. Coffey, Christopher S.; Asselbergs, Folkert W.; Hebert, Patricia R.; Hillege, Hans L.; Qing Li; Moore, Jason H.; van Gilst, Wiek H. // Cardiology Research & Practice; 

    Background. We used a random sample (n = 2, 495) from the population-based Prevention of Renal and Vascular End-stage Disease (PREVEND) study population to examine the association of the metabolic syndrome (Met S) with plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen...

  • 2007 - Glomerular filtration rate less than 45 mL/min/1.73 m2 with microalbuminuria was associated with increased risk for CV death. Rifkin, Dena E.; Sarnak, Mark J. // ACP Journal Club;5/20/2008, Vol. 148 Issue 3, p13 

    The article presents information on a case study which ascertained whether the combination of estimated glomerular filtration rate (EGFR) and urine albumin excretion can correctly predict cardiovascular death. About 9709 people in the mean age of 62 were included in the study. Multivariate...

  • Microalbuminuria and the Hypertensive Disorders of Pregnancy. C�t�, Anne-Marie; von Dadelszen, Peter; Moutquin, Jean-Marie; Ardilouze, Jean-Luc; Magee, Laura A. // Current Hypertension Reviews;2010, Vol. 6 Issue 1, p8 

    Microalbuminuria measurement is now widely available, but its use during and after pregnancy has not been clearly defined. This review will present a brief overview of microalbuminuria measurement and screening outside pregnancy, and discuss the diagnosis of microalbuminuria in pregnancy, the...

Share

Read the Article

Courtesy of your local library

Public Libraries Near You (See All)
Looking for a Different Library?

Other Topics