Abstract
It has been reported recently that spot albumin-creatinine ratio predicts left ventricular hypertrophy in young hypertensive African-American men. To test this, we studied 2300 untreated, non diabetic Caucasian patients with essential hypertension, 1271 men and 1029 women, 51.4±12.4 years old. Urinary albumin and creatinine were measured over 24 hours and their ratio (ACR) was calculated, while left ventricular hypertrophy (LVH) was determined by echocardiogram. Patients with LVH had higher ACR (38.3 vs 19.7 mg/g p<0.0001), with higher values in patients with eccentric LVH (39.1 mg/g), differentiating among LV geometry patterns (F=82 p<0.0001). Patients with ACR >30mg/g had higher LV mass index values (145 vs 133 g/m2 p<0.0001) and higher LVH incidence (71.8 vs 37.3% p<0.0001). Thus, the sensitivity of increased ACR in predicting LVH was rather low (46.5%) but the specificity was high (83.2%) with odds ratio 4.3:1. The relationship of ACR to LV mass index was strong (r=0.365) and remained significant after correction for age (r=0.311), diastolic blood pressure (r=0.309) or serum creatinine (r=0.254). It is concluded that elevated ACR is a high specific marker of LVH in hypertensive patients.
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