Association Between Microalbuminuria and Pulse Pressure Among Patients with Isolated Systolic and Diastolic Hypertension

Abstract

Background: The aim of this study is to examine the prevalence and predictors of microalbuminuria and to investigate the association between microalbuminuria and pulse pressure among patients with isolated systolic and diastolic hypertension. Materials and methods: In this cross-sectional study, patients with diastolic hypertension (DH) and isolated systolic hypertension (ISH) were included. Data including patient age, sex, duration of HT, comorbidities, and drugs were recorded. Serum total cholesterol (TC), HDL cholesterol (HDL), triglyceride (TG), urea, creatinine, fasting blood glucose and urinalysis and electrocardiograph (ECG), transthoracic echocardiography (TTE), exercise stress test (EST), and coronary angiography (if the patient had a positive EST result) were performed. Results: Overall, we included 183 patients (58.5% female) with hypertension. The patients with ISH had significantly higher pulse pressure, left ventricular mass, and left ventricular mass index, but had a shorter duration of HT and lower diastolic blood pressure than those with DH. All patients were in sinus rhythm, and there were no ischemic ECG changes. Fifty-nine (%32.2) patients had MA (microalbuminuria ≥20 µg/min). Left ventricular mass, LVMI, left atrial diameter, E/A ratio, systolic blood pressure, pulse pressure, and frequency of LVH were significantly higher in patients with MA than patients without MA. The prevalence of angiographically proven atherosclerotic heart disease was similar in patients with and without microalbuminuria. Multivariate binary logistic regression analysis revealed that only systolic pressure and left atrial diameter were independent associates of microalbuminuria. Each 1 mmHg increase in systolic blood pressure was associated with a 3% increase in the risk of having microalbuminuria (p=0.04). In addition, each 1 mm increase in the diameter of the left atrium increased the risk of having microalbuminuria by 20% (p=0.02). Conclusion: This study demonstrated that microalbuminuria in hypertensive patients was independently associated with left atrial size and systolic blood pressure, but not with pulse pressure.