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Review
. 2004 Nov;6(11 Suppl 3):13-7.
doi: 10.1111/j.1524-6175.2004.04234.x.

Cardiovascular implications of albuminuria

Katherine R Tuttle  1
Affiliations
Review

Cardiovascular implications of albuminuria

Katherine R Tuttle. J Clin Hypertens (Greenwich). 2004 Nov.

Abstract

Microalbuminuria is a major independent risk factor for cardiovascular disease (CVD) events in persons with diabetes or hypertension, the general population, and persons with known CVD. Although microalbuminuria is a stronger risk factor in men, women with increased albuminuria levels are also at a higher risk of CVD. Microalbuminuria is an indicator of generalized endothelial injury, a hallmark of systemic atherosclerosis. Treatments that decrease albuminuria, particularly agents that inhibit the renin-angiotensin system, reduce CVD risk in various populations, including those with and without diabetes or hypertension. Whether albuminuria should be a treatment target for CVD is not yet proven. Nevertheless, the measurement of albuminuria is clinically useful to identify high-risk individuals who should receive intensive risk factor management based on current treatment guidelines.

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Figures

Figure 1
Figure 1
Association of microalbuminuria and cardiovascular morbidity and mortality in type 2 diabetes. Odds ratios of cardiovascular morbidity and mortality in patients with type 2 diabetes with microalbuminuria vs. normoalbuminuria. Reprinted with permission from Arch Intern Med. 1997;157:1413–1418. 2 Copyright 1997, American Medical Association. All Rights Reserved.
Figure 2
Figure 2
Survival without ischemic heart disease in hypertensive subjects by albuminuria status. Reprinted with permission from Hypertension. 2000;35:898–903. 3
Figure 3
Figure 3
Risk of cardiovascular death by albuminuria level in the general population. Reprinted with permission from Circulation. 2002;106:1777–1782. 4
Figure 4
Figure 4
Urinary albumin and severity of coronary artery disease. *p=0.027 vs. Absent and Mild groups Reprinted from Am J Kidney Dis. 1999;34:918–925. Copyright 1999, with permission from the National Kidney Foundation. 8
Figure 5
Figure 5
Glomerular structure
Reprinted from Tuttle KR, Stein JH. Diabetic nephropathy. Current Concepts. Kalamazoo, MI: The Upjohn Company; 1989. With permission of Pfizer Inc.
See this image and copyright information in PMC

References

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