[Microalbuminuria-related cardiovascular risk in diabetic patients and hypertensive (non diabetic) population]. / Riesgo cardiovascular asociado a microalbuminuria en pacientes diabéticos y en pacientes con hipertensión arterial.

BACKGROUND AND OBJECTIVE: The MICREX Study has shown an high prevalence of microalbuminuria in Extremadura among diabetic patients and hypertensive population. It has been retrospectively evaluated the cardiovascular risk associated to microalbuminuria and/or diabetes mellitus. PATIENTS AND METHOD: A total of 902 patients older than 18 years were studied (mean age, 68.7 [11.0] years; 370 men and 532 women; 469 were diabetics and 433 non diabetic hypertensives). Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Anthropometric measures and previous cardiovascular diseases were recorded. RESULTS: Odds ratio of cardiovascular disease for all patients with microalbuminuria was 1.91 (confidence interval [CI] 95%, 1.31-2.78; p = 0.001), for diabetic group it was 1.87 (CI 95%, 1.15-3.04; p = 0.01) and for non diabetic hypertensives 1.78 (CI 95%, 0.98-3.30; p = 0.06). The risk associated to all patients with diabetes mellitus (versus non diabetic hypertensives) showed an odds ratio = 1.59 (CI 95%, 1.19-2.14; p = 0.02). Hypertension in diabetic subjects rises odds ratio up to 2.13 (CI 95%, 1.30-3.48; p = 0.002). When hypertensives diabetics were compared to non diabetic hypertensives odds ratio was 1.88 (CI 95%, 1.37-2.57; p < 0.0001). CONCLUSIONS: In a retrospective view microalbuminuria and diabetes mellitus were positively related to a higher risk of cardiovascular disease. Microalbuminuria and/or hypertension in diabetic patients were also associated to higher cardiovascular risk.

Riesgo cardiovascular asociado a microalbuminuria en pacientes diabéticos y en pacientes con hipertensión arterial / Microalbuminuria-related cardiovascular risk in diabetic patients and hypertensive (non diabetic) population

Fundamento y objetivo: El estudio MICREX ha demostrado que la microalbuminuria es un problema de gran prevalencia en Extremadura. Se ha valorado retrospectivamente la aparición de complicaciones cardiovasculares clínicas o subclínicas en los pacientes estudiados (diabéticos y/o hipertensos), calculando su riesgo en función de que tuvieran microalbuminuria y/o diabetes mellitus o no las tuvieran. Pacientes y método: Para el análisis se ha utilizado los datos de 902 pacientes, con una media (desviación estándar) de edad de 68,7 (11) años; 370 eran varones y 532, mujeres; 469 eran diabéticos y 433, hipertensos sin diabetes. De cada paciente se realizó una determinacion con tira semicuantitativa de albuminuria/creatininuria en muestra de orina de primera hora de la mañana y en ayunas. En todos los casos se realizaron mediciones antropométricas y se registraron las enfermedades cardiovasculares asociadas. Resultados: La odds ratio (OR) del riesgo de tener complicaciones cardiovasculares por microalbuminuria fue de 1,91 (intervalo de confianza [IC] del 95%, 1,31-2,78; p = 0,001) en el total de la muestra; para los diabéticos, 1,87 (IC del 95%, 1,15-3,04; p = 0,01) y para los hipertensos, 1,78 (IC del 95%, 0,98-3,30; p = 0,06). El riesgo asociado a diabetes mellitus mostraba una OR = 1,59 (IC del 95%, 1,19-2,14; p = 0,02). La hipertensión arterial en los enfermos diabéticos aumentaba la OR a 2,13 (IC del 95%, 1,30-3,48; p = 0,002). Cuando se comparó a los diabéticos hipertensos con los hipertensos sin diabetes, la OR era 1,88 (IC del 95%, 1,37-2,57; p < 0,0001). Conclusiones: Valoradas de forma retrospectiva, la microalbuminuria y la diabetes mellitus tienen relación directa con un riesgo de enfermedades cardiovasculares aumentado. La microalbuminuria y/o la hipertensión arterial en un paciente diabético también tienen relación con mayor riesgo cardiovascular

Background and objective: The MICREX Study has shown an high prevalence of microalbuminuria in Extremadura among diabetic patients and hypertensive population. It has been retrospectively evaluated the cardiovascular risk associated to microalbuminuria and/or diabetes mellitus. Patients and method: A total of 902 patients older than 18 years were studied (mean age, 68.7 [11.0] years; 370 men and 532 women; 469 were diabetics and 433 non diabetic hypertensives). Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Anthropometric measures and previous cardiovascular diseases were recorded. Results: Odds ratio of cardiovascular disease for all patients with microalbuminuria was 1.91 (confidence interval [CI] 95%, 1.31-2.78; p = 0.001), for diabetic group it was 1.87 (CI 95%, 1.15-3.04; p = 0.01) and for non diabetic hypertensives 1.78 (CI 95%, 0.98-3.30; p = 0.06). The risk associated to all patients with diabetes mellitus (versus non diabetic hypertensives) showed an odds ratio = 1.59 (CI 95%, 1.19-2.14; p = 0.02). Hypertension in diabetic subjects rises odds ratio up to 2.13 (CI 95%, 1.30-3.48; p = 0.002). When hypertensives diabetics were compared to non diabetic hypertensives odds ratio was 1.88 (CI 95%, 1.37-2.57; p < 0.0001). Conclusions: In a retrospective view microalbuminuria and diabetes mellitus were positively related to a higher risk of cardiovascular disease. Microalbuminuria and/or hypertension in diabetic patients were also associated to higher cardiovascular risk

Microalbuminuria en pacientes diabéticos y en pacientes con hipertensión arterial: estudio de una cohorte de 979 pacientes / Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients

Fundamento y objetivo: Aunque la microalbuminuria es una complicación conocida de la diabetes mellitus, también es un factor de riesgo cardiovascular presente en población hipertensa sin diabetes mellitus. Su prevalencia es variable según las zonas estudiadas y nunca se la ha examinado en Extremadura. El estudio MICREX ha intentado estimar la prevalencia de este problema en nuestra región. Pacientes y método: Se incluyó en el estudio a pacientes diabéticos o hipertensos que no fueran diabéticos seleccionados aleatoriamente. De cada paciente, se realizó una medición con tira semicuantitativa de albuminuria/creatininuria en muestra de orina de primera hora de la mañana y en ayunas. Siempre que fue posible, se complementó con la cuantificación de microalbuminuria y creatinina en orina de primera hora de la mañana. Resultados: Se ha incluido a 979 pacientes (media de edad [desviación estándar], 67,9 [10,8] años; 409 varones y 570 mujeres), de los que 505 eran diabéticos. Un 12,4% de los hipertensos presentaban microalbuminuria, frente al 21,4% de los diabéticos (p < 0,001). La tasa de microalbuminuria de hipertensos y diabéticos normotensos era parecida (13,3%, no significativa), pero se triplicaba en los diabéticos hipertensos (33,8%; p < 0,01). No hubo diferencias en el control glucémico entre diabéticos con microalbuminuria y quienes no la presentaban. La prevalencia de microalbuminuria no era menor en los pacientes tratados con fármacos antagonistas del eje renina-angiotensina (diabéticos, 23,5%; hipertensos, 10,5%). El resultado de la tira reactiva se confirmó mediante determinación en laboratorio en el 65,4% de los casos. Conclusiones: La microalbuminuria es de elevada prevalencia en Extremadura, tanto en diabéticos como en pacientes no diabéticos. La microalbuminuria en diabéticos se correlaciona con la hipertensión arterial, pero no con el control glucémico. A pesar del tratamiento con antagonistas del eje renina-angiotensina, la prevalencia de microalbuminuria es elevada

Background and objective: Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). Patients and method: The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. Results: A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. Conclusions: The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs

[Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients]. / Microalbuminuria en pacientes diabéticos y en pacientes con hipertensión arterial: estudio de una cohorte de 979 pacientes.

BACKGROUND AND OBJECTIVE: Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). PATIENTS AND METHOD: The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. RESULTS: A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. CONCLUSIONS: The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.