Systemic hypertension
Relation of Microalbuminuria to Adiponectin and Augmented C-Reactive Protein Levels in Men With Essential Hypertension

https://doi.org/10.1016/j.amjcard.2005.05.052Get rights and content

Microalbuminuria, and recently, hypoadiponectinemia, have been associated with progression of atherosclerotic disease and increased cardiovascular risk. We examined the possible associations of urinary albumin excretion, expressed as the ratio of albumin to creatinine (ACR), with plasma adiponectin and high-sensitivity C-reactive protein (hs-CRP) levels in men who had essential hypertension. The study population consisted of 108 men who did not have diabetes and were newly diagnosed with stage I to II essential hypertension (age 44.6 years, office blood pressure 148/95 mm Hg) and 110 men matched according to age and body mass index as controls. According to ACR values, which were determined as the average of 2 nonconsecutive overnight spot urine samples, subjects who had hypertension were categorized into 2 groups: those who had microalbuminuria (n = 28; mean ACR 30 to 300 mg/g) and those who had normal albuminuria (n = 80; mean ACR <30 mg/g). Subjects who had hypertension compared with controls exhibited higher ACR and log hs-CRP levels and a trend toward lower log adiponectin values (p = 0.062), whereas those who had normal albuminuria compared with controls had similar log adiponectin levels but significantly higher levels of ACR and log hs-CRP. Moreover, subjects who had hypertension and microalbuminuria compared with those who had hypertension and normal albuminuria had higher log hs-CRP and lower log adiponectin concentrations independently of confounding factors. Among those who had hypertension, ACR exhibited an independent positive correlation with log hs-CRP and a negative correlation with log adiponectin. Multiple linear regression analysis showed that age, body mass index, systolic blood pressure, log hs-CRP, and log adiponectin were significant independent predictors of the ACR. In conclusion, microalbuminuria is accompanied by decreased adiponectin and increased hs-CRP levels in the setting of essential hypertension, reflecting a rather diffuse atherosclerotic process.

Section snippets

Study participants

The study population consisted of 149 consecutive men who had newly diagnosed (within the previous 2 years), untreated stage I/II essential hypertension, were 30 to 65 years of age, and were referred or self-referred to the outpatient hypertension unit within a period of 6 months.13 Secondary forms of hypertension were excluded according to established diagnostic methods.13, 14

Exclusion criteria included heart failure, atherosclerotic cardiovascular disease, diabetes mellitus or glucose

Results

Subjects who had hypertension (n = 108) compared with controls (n = 110) did not differ with regard to age, BMI, waist-to-hip ratio, lipid profile, hemoglobin A1c, and fasting glucose levels (p = NS for all cases) but exhibited a higher ACR (by 9.65 mg/g, p <0.0001), log hs-CRP levels (by 0.14 mg/L, p <0.0001), greater left ventricular mass index (107 ± 12 vs 96 ± 14 g/m2, p <0.05), and greater relative wall thickness (0.41 ± 0.07 vs 0.38 ± 0.02, p <0.05). There was also a trend toward lower

Discussion

The main finding of our study is that an inverse relation exists between ACR and adiponectin, a novel circulating antiatherogenic adipose-specific protein, in men who are newly diagnosed with essential hypertension. Moreover, microalbuminuria is accompanied not only by increased levels of an established inflammatory marker, such as hs-CRP, but also by attenuated levels of adiponectin in this setting.

In our study, subjects who had hypertension compared with controls exhibited a trend toward

References (30)

  • H.D. Sesso et al.

    C-reactive protein and the risk of developing hypertension

    JAMA

    (2003)
  • G. Schillaci et al.

    Increased C-reactive protein concentrations in never-treated hypertensionthe role of systolic and pulse pressures

    J Hypertens

    (2003)
  • S. Takiuchi et al.

    Diagnostic value of carotid intima-media thickness and plaque score for predicting target organ damage in patients with essential hypertension

    J Hum Hypertens

    (2004)
  • H. Hashimoto et al.

    Relationship between C-reactive protein and progression of early carotid atherosclerosis in hypertensive subjects

    Stroke

    (2004)
  • Y. Iwashima et al.

    Hypoadiponectinemia is an independent risk factor for hypertension

    Hypertension

    (2004)
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