Baseline microalbuminuria, and the slopes for both systolic blood pressure and fasting glucose can predict the risk of microalbuminuria during antihypertensive therapy.
Researchers from the University of Valencia and other Spanish centres enrolled 187 patients with essential hypertension, aged less than 50 years, who had not received antihypertensives and who did have diabetes mellitus. Of these, 62 patients were managed without drugs, while 38 received beta-blockers and 64 took ACE inhibitors. Eight and 15 respectively received calcium channel blockers or other drugs. Patients were followed for 2.7 years.
Twenty-two patients – 11.7 percent – developed microalbuminuria, equivalent to a yearly rate of 4.4 per 100 patients. Those subjects who developed microalbuminuria did not differ from normo-albuminuric patients in any of several variables: age, gender, body mass index, disease duration, blood pressure, biochemical profile, familial history of diabetes or hypertension, smoking or left ventricular hypertrophy.
Patients who received ACE inhibitors were the least likely to develop microalbuminuria (annual rate: 2.9 per 100 patients). The annual rate of microalbuminuria was also relatively low in those managed with diet or beta-blockers (3.3 and 4.1 per 100 patients respectively).
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