Is microalbuminuria related to carotid abnormalities in elderly subjects?

MATILDE OTERO-LOSADA; JORGE H ALTAMIRANO; DIEGO SANCHEZ GELOS; JOSE MILEI

Milán

Congreso; 21st. European Meeting on Hypertension (ESH); 2011

European Meeting on Hypertension (ESH)

PURPOSE. To assess the relationship between carotid artery wall morphology and microalbuminuria and to identify potentially implicated factors. METHODS. 47 patients >65 years old (35 women, 73±1 years and 12 men, 76±2 years) underwent a 24 h ambulatory blood pressure (BP) monitoring. Carotid doppler ultrasound scan and a complete clinical evaluation were performed. Pulse wave velocity (PWV) was obtained from carotid and femoral arteries’ digitized BP values. Carotid damage was evidenced by the presence of intima-media complex thickening (IMT) and/or parietal plaques. Morning surge (MS): mean systolic BP of the 2-h after awakening minus mean systolic BP of the 1-h night interval showing the lowest sleep systolic BP (Kario). Blood levels of triglycerides (TG), glucose, cholesterol (total and HDL and LDL fractions) were determined. Statistics: zero order bivariate associations and partial correlations, after removing the effect of one or more variables, were performed in order to identify potentially relevant or confounding factors (alternative Pearson/ product-moment correlation). RESULTS. (I). The degree of carotid damage was directly associated with microalbuminuria (R= 0.36, p<0.03; R2= 0.13, 13% of reciprocal variation explained) and age (R= 0.42, p<0.003). Age explained 18% of variation in carotid damage (R2= 0.18). (II). Carotid damage and microalbuminuria accounted for 20% of each other variation (R2= 0.20) after removal of potentially confounding factors (simultaneously controlling for the effects of smoking, body weight, LDL, total cholesterol, diastolic diameter and arterial pressure variability, R= 0.45, p<0.02). (III). Carotid damage-microalbuminuria correlation (CMr) was abolished after controlling for TG (R= 0.35, N.S), glycemia (R= 0.30, N.S.) or PWV (R= 0.32, N.S.). (IV). Holding hypertension constant had no effect on CMr (R= 0.36, p<0.03) showing that hypertension was not implicated in CMr. (V) CMr was strengthened (R= 0.38, p<0.02) after controlling for smoking effects. (VI). Neither MS (R= 0.23, N.S.) or PWV (R= 0.18, N.S.) were related to carotid damage. CONCLUSIONS. A weak but consistent correlation was found between carotid damage and microalbuminuria. Presented evidence supports the idea that pulse wave velocity, triglyceridemia and glycemia might be involved in the relationship between carotid wall damage and microalbuminuria.