Abstract 2998: Aortic Stiffness Is Correlated With Albuminuria and Glomerular Filtration Rate in Essential Hypertension: The Hippokration Hellenic Hypertension (3H) Study

Abstract

Introduction: Arterial stiffness is an established marker of cardiovascular risk, whereas albuminuria and impaired renal function are associated with atherosclerosis progression. Hypothesis: Arterial stiffness may be associated with urinary albumin excretion, expressed as the albumin to creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) in a large cohort of hypertensives. Methods: A total of 893 consecutive essential hypertensives [482 men, mean age = 56 years, office blood pressure (BP) = 145/90 mmHg] that were included in the Hippokration Hellenic Hypertension (3H) Study, an ongoing Greek registry of hypertension-related target organ damage, were considered for analysis. In all participants, ACR values were determined as the mean of two non-consecutive morning spot urine and eGFR was calculated using the Modification of Diet in Renal Disease equation. Moreover, aortic stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV), by means of a computerized method (Complior SP). The distribution of PWV was split by the median (8 m/sec) and accordingly subjects were stratified into those with high and low values. Results: Hypertensive patients with high PWV (n = 414) compared to those with low PWV values (n = 479) were older (61 ± 10 vs 51 ± years, p < 0.0001), had higher office systolic BP (150 ± 9 vs 142 ± 6mmHg, p < 0.0001) and left ventricular mass index (107.7 ± 16 vs 99 ± 13 g/m 2 , p < 0.0001). Moreover, hypertensives with high PWV compared to those with low PWV exhibited higher ACR (18.7 ± 9.5 vs 14.8 ± 7.5 mg/g, p < 0.05), whereas had lower eGFR (76 ± 17 vs 82 ± 17 ml/min/1.73m 2 , p = 0.006). In the total population, PWV was related to age (r = 0.525, p < 0.0001), office systolic BP (r = 0.242, p = 0.0001), ACR (r = 0.012, p < 0.001) and negatively associated with eGFR (r = −0.221, p < 0.0001). Analysis of covariance revealed that ACR and eGFR levels remained significantly different between groups after adjustment for confounders (p < 0.05). Conclusions: In essential hypertension, heightened PWV values are associated with pronounced albuminuria and impaired kidney function. These findings further support that aortic stiffening is a hallmark of diffuse renal and vascular atherosclerotic disease.