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Shahrir NF, Aziz NRA, Ahmad FL, Muzaid NA, Samat F, Syed Ghazaili SNA, Dolbasir N, Baharum NN, T Ramanathan S, Abd Rahman SZ, Bat AS, Sarif M, Ismaal NA. Determinants of microalbuminuria among type 2 diabetes mellitus patients in Kuala Selangor district: A cross-sectional study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:53-63. [PMID: 36606172 PMCID: PMC9809433 DOI: 10.51866/oa.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Microalbuminuria presents significant health risks for the progression of endstage renal-failure (ESRF) among type 2 diabetes mellitus (T2DM) patients. This study aims to determine the proportion and associated factors of microalbuminuria among T2DM patients in Kuala Selangor district, Malaysia. METHOD A retrospective cross-sectional study was conducted from December 2020 to February 2021 using secondary data from the National Diabetic Registry (NDR), Malaysia, and reviewed patients' diabetic records for the year 2020. All T2DM patients aged >18 years who were registered with the NDR in 2020 and fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were performed. Data were analysed using SPSS version 26.0. A total of 343 samples were included in this study for the determination of the proportion of microalbuminuria and its associated factors. RESULTS Of 343 respondents, 34.4% had microalbuminuria. HbAlc >7.0% (AdjOR 2.19, 95% CI: 1.35, 3.55, p=0.001), HDL <1.04 mmol/L (AdjOR 2.44, 95% CI: 1.323, 4.52, p=0.004), dyslipidaemia (AdjOR 1.90, 95% CI: 1.03, 3.48, p=0.039), and peripheral neuropathy (AdjOR 3.01, 95% CI: 1.02, 8.93, p=0.047) were significantly associated with microalbuminuria. Conclusion: Microalbuminuria is a modifiable risk factor in preventing the progression of ESRF among T2DM patients. Therefore, identification of factors associated with microalbuminuria among this high-risk group is important to facilitate early screening and prompt treatment to prevent progression of diabetic kidney disease to ESRF.
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Affiliation(s)
- Nurul Farehah Shahrir
- MBBS (UiTM), MPH, DrPH (USM) Pejabat Kesihatan Daerah Kuala, Selangor, Jalan Semarak, Bandar, Melawati, Kuala Selangor, Malaysia.
| | - Noor Rafizah Aminah Aziz
- MBBS (UM), MPH (USM) Pejabat Kesihatan Daerah Kuala, Selangor, Jalan Semarak, Bandar, Melawati, Kuala Selangor, Malaysia
| | - Fatimah Lailiza Ahmad
- MD(UKM) Pejabat Kesihatan Daerah Kuala, Selangor, Jalan Semarak, Bandar, Melawati, Kuala Selangor, Malaysia
| | - Nor Anizah Muzaid
- MD(UKM) MMed(Family Medicine) (UKM) Klinik Kesihatan Kuala Selangor, Jalan Klinik, Bandar Malawati, Kuala, Selangor, Malaysia
| | - Farhani Samat
- MD(UKM) MMed (Family Medicine) UiTM, Klinik Kesihatan Tanjong karang, Kuala Selangor, Malaysia
| | | | - Nuraini Dolbasir
- MD (UKM), MMed (Family Medicine) (UM) Klinik Kesihatan Jeram, Jalan Klang-Telok Intan, Jeram, Malaysia
| | - Nurul Nadia Baharum
- MBBS (IIUM), MMed (Family Medicine) (UiTM) Klinik Kesihatan Bukit Cherakah, Jalan Rizab Masjid, Jeram, Malaysia
| | - Sharmilee T Ramanathan
- MBBS (MAHE,MANIPAL)(FRACGP/MAFP) Klinik Kesihatan Ijok, JKR 1087, Jalan 14, Ijok, Batang Berjuntai, Malaysia
| | | | - Ap Sa'aidah Bat
- MD (USU) Klinik Kesihatan Bukit Cherakah, Jln Rizab Masjid, Kg. Bukit Cherakah, Jeram, Malaysia
| | - Maznah Sarif
- Diploma Kejururawatan, Klinik Kesihatan Bukit Cherakah, Jln Masjid, Jeram, Malaysia
| | - Noor Afiza Ismaal
- Diploma Kejururawatan, Klinik kesihatan Sg Tengi Kanan, Jalan Kiai Moid, Tanjung Karang, Malaysia
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Gaeini Z, Bahadoran Z, Mirmiran P, Norouzirad R, Ghasemi A, Azizi F. Spot urinary microalbumin concentration, metabolic syndrome and type 2 diabetes: Tehran lipid and glucose study. BMC Endocr Disord 2022; 22:59. [PMID: 35260113 PMCID: PMC8905801 DOI: 10.1186/s12902-022-00976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 02/28/2022] [Indexed: 11/30/2022] Open
Abstract
AIM This study aimed to determine the association of urinary microalbumin concentrations with type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), and its phenotypes. The optimum cut-off values of urinary microalbumin and microalbumin-to-creatinine ratio (MCR) for predicting the chance of having T2DM and MetS were also defined. METHODS Adult men and women (n = 1192) participated in the sixth phase (2014-2017) of the Tehran Lipid and Glucose Study (TLGS), with completed data, were included in the analyses. Odds ratios (ORs) (and 95% confidence intervals (CIs)) of T2DM, MetS, and its components across tertile categories of urinary microalbumin concentrations were estimated using multivariable logistic regressions. The optimal cut-off points of urinary microalbumin and MCR were determined using the receiver operator characteristic (ROC) curve analysis. RESULTS Participants' mean (±SD) age was 44.9 (±14.0) years, and 44.6% of the participants were men. The prevalence of microalbuminuria was 14.4%. Chance of having T2DM was significantly higher in the highest tertile of urinary microalbumin concentration (OR = 2.29, 95% CI = 1.43-3.67) and MCR (OR = 1.82, 95% CI = 1.15-2.89). Subjects with the highest urinary microalbumin concentration were more likely to have MetS (OR = 1.66, 95% CI = 1.17-2.35), hypertension (OR = 1.63, 95% CI = 1.16-2.30) and hyperglycemia (OR = 1.78, 95% CI = 1.24-2.56). No significant association was observed between urinary microalbumin concentrations and other components of MetS. The optimal cut-off points of urinary microalbumin for predicting the chance of having T2DM and MetS were 14.0 and 13.6 mg/L, respectively. CONCLUSIONS Elevated spot urinary microalbumin, below the values defined as microalbuminuria, was associated with the chance of having T2DM and MetS.
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Affiliation(s)
- Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Reza Norouzirad
- Department of Biochemistry, School of Paramedical Sciences, Dezful University of Medical Sciences, Dezful, Iran
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tsuda S, Nakayama M, Matsukuma Y, Yoshitomi R, Haruyama N, Fukui A, Nakano T, Tsuruya K, Kitazono T. Subclinical hypothyroidism is independently associated with poor renal outcomes in patients with chronic kidney disease. Endocrine 2021; 73:141-150. [PMID: 33474711 DOI: 10.1007/s12020-021-02611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE It remains unclear whether subclinical hypothyroidism (SCH) is associated with renal prognosis in patients with chronic kidney disease (CKD). Therefore, we prospectively investigated the association of SCH with renal outcomes in CKD. METHODS We conducted a prospective observational study of 480 euthyroid patients and 89 patients with SCH. The endpoints were defined as a composite of doubling of serum creatinine (SCr), end-stage renal disease (ESRD), or death, and a composite of doubling of SCr or ESRD was added as an alternative outcome. Logistic regression analyses were used to identify the factors associated with SCH. In addition, a Cox proportional hazards model was performed to determine whether SCH was associated with poor renal outcomes. RESULTS During a median follow-up period of 26.1 months, doubling of SCr, ESRD, or death and doubling of SCr or ESRD occurred in 244 and 213 patients, respectively. In univariable logistic regression analyses, SCH was significantly associated with older age, lower hemoglobin, higher proteinuria, lower estimated glomerular filtration rate (eGFR), and higher log B-type natriuretic peptide (BNP). Multivariable Cox analyses showed that SCH was associated with poorer renal outcomes after adjustment for covariates, including eGFR and log BNP [doubling of SCr, ESRD, or death: hazard ratio (HR) 1.61, 95% confidence interval (CI), 1.16-2.23; doubling of SCr or ESRD: HR 1.53, 95% CI 1.07-2.20], compared with euthyroidism. CONCLUSIONS In CKD, SCH is independently associated with poor renal outcomes, suggesting that screening for SCH might be needed to accurately predict renal prognosis.
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Affiliation(s)
- Susumu Tsuda
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Masaru Nakayama
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan.
| | - Yuta Matsukuma
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Ryota Yoshitomi
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Naoki Haruyama
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Akiko Fukui
- Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan
| | - Toshiaki Nakano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuhiko Tsuruya
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Manolis A, Doumas M, Ferri C, Mancia G. Erectile dysfunction and adherence to antihypertensive therapy: Focus on β-blockers. Eur J Intern Med 2020; 81:1-6. [PMID: 32693940 DOI: 10.1016/j.ejim.2020.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/15/2020] [Accepted: 07/15/2020] [Indexed: 11/19/2022]
Abstract
The management of arterial hypertension is very challenging in everyday clinical practice. Blood pressure control rates remain disappointingly low, despite intense efforts. Poor adherence to antihypertensive treatment is among the main causes of inadequate blood pressure control. Among the various parameters leading to poor adherence, medication adverse events seem to be the prevailing cause of treatment discontinuation. Β-blockers are a class of drugs commonly used in the management of hypertension. However, β-blockers use has been associated with various adverse events, among which, erectile dysfunction is a prevalent one. Accumulating evidence supports the detrimental role of β-blockers on erectile function. Older studies have shown contradictory findings, which however may be attributed to methodological errors related with the assessment of erectile function. More recent studies, however, unveiled the negative impact of this drug category on erectile function. Nevertheless, β-blockers represent a class of drugs with substantial within class heterogeneity. Nebivolol presents a unique mode of action through enhanced nitric oxide bioavailability that may be associated with benefits on erectile function. Indeed, studies of nebivolol have shown improvement in erectile function, suggesting that nebivolol represents the only exception in this class of drugs in terms of erectile function.
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Affiliation(s)
| | - Michael Doumas
- 2nd Prop. Department of Internal Medicine, Aristotle University, 126, Vas. Olgas street, 54645 Thessaloniki, Greece.
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Moh AMC, Pek SLT, Liu J, Wang J, Subramaniam T, Ang K, Sum CF, Kwan PY, Lee SBM, Tang WE, Lim SC. Plasma osteoprotegerin as a biomarker of poor glycaemic control that predicts progression of albuminuria in type 2 diabetes mellitus: A 3-year longitudinal cohort study. Diabetes Res Clin Pract 2020; 161:107992. [PMID: 32032675 DOI: 10.1016/j.diabres.2019.107992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/10/2019] [Accepted: 12/20/2019] [Indexed: 11/30/2022]
Abstract
AIMS Poor glycaemic control elevates the risk for vascular complications. Biomarkers for predicting susceptibility to glycaemic worsening are lacking. This 3-year prospective analysis assessed the utility of several circulating diabetes-related biomarkers for predicting loss of glycaemic control, and their contribution to albuminuria progression in type 2 diabetes mellitus (T2DM). METHODS T2DM subjects with adequately-controlled diabetes (HbA1c < 8%) at initial recruitment were analysed (N = 859). Baseline plasma levels of osteoprotegerin (OPG), C-reactive protein (CRP), adiponectin, intercellular-cell adhesion molecule-1, and vascular-cell adhesion molecule-1 were quantified using immunoassay. Definitions for development of uncontrolled diabetes and albuminuria progression were HbA1c ≥ 8.0% and increase in albuminuria category at follow-up, respectively. RESULTS At follow-up, 185 subjects developed uncontrolled diabetes. Higher baseline CRP and OPG levels were observed in the high-risk individuals, and predicted increased risk for developing uncontrolled diabetes. OPG, but not CRP, was associated with albuminuria progression after multivariable adjustment. The relationship was attenuated following adjustment for development of uncontrolled diabetes, which emerged as a significant associate. Mediation analysis revealed that loss of glycaemic control explained 64.5% of the relationship between OPG and albuminuria progression. CONCLUSIONS OPG outperformed other diabetes-related biomarkers to be a potentially useful biomarker for predicting loss of glycaemic control and its associated albuminuria deterioration.
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Affiliation(s)
| | | | - Jianjun Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Jiexun Wang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Tavintharan Subramaniam
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - Pek Yee Kwan
- National Healthcare Group Polyclinics, Singapore
| | | | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore
| | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore; Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore; Saw Swee Hock School of Public Health, National University Hospital, Singapore.
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Liu M, Zhang Z, Zhou C, He P, Nie J, Liang M, Liu C, Xu F, Liao G, Zhang Y, Li J, Wang B, Wang X, Huo Y, Xu X, Qin X. Relationship of Body Mass Index and Waist Circumference With Risk of New-Onset Proteinuria in Hypertensive Patients. J Clin Endocrinol Metab 2020; 105:5715422. [PMID: 31976527 DOI: 10.1210/clinem/dgaa026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/15/2020] [Indexed: 01/24/2023]
Abstract
CONTEXT The association of the combination of body mass index (BMI) and waist circumference (WC) with the risk of proteinuria has previously not been comprehensively investigated and results have been inconclusive. OBJECTIVE To examine BMI and WC in relation to new-onset proteinuria in Chinese hypertensive patients. DESIGN AND SETTING Post hoc analysis of the renal substudy of the China Stroke Primary Prevention Trial (CSPPT). PATIENTS 10 805 hypertensive patients without proteinuria at baseline. MAIN OUTCOME MEASURE The primary outcome was new-onset proteinuria, defined as a urine dipstick protein reading ≥ 1 + at the exit visit, after a median follow-up duration of 4.4 years. RESULTS When analyzed separately, increased BMI (≥ 28 kg/m2, quartile 4; odds ratio [OR], 1.36; 95% confidence interval [CI], 1.08-1.72), or increased WC (≥ 91cm for females, quartile 4; OR, 1.35; 95% CI, 1.01-1.80; and ≥ 79 cm for males, quartile 2-4; OR, 1.60; 95% CI, 1.03-2.50) were each significantly associated with higher risk of new-onset proteinuria. When analyzed jointly, participants without increased BMI and increased WC had the lowest risk, while those with both increased BMI and increased WC had the highest risk of proteinuria (OR, 1.61; 95% CI, 1.21-2.13). Notably, participants with only increased WC also had significantly increased risk of proteinuria (OR, 1.39; 95% CI, 1.04-1.85). CONCLUSION In Chinese hypertensive patients, increased BMI and increased WC were individually and jointly associated with a higher risk of new-onset proteinuria, underscoring the value of monitoring both BMI and WC in assessing proteinuria risk.
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Affiliation(s)
- Mengyi Liu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuxian Zhang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chun Zhou
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Panpan He
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Nie
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Liang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | - Fanghua Xu
- Department of Cardiology, Xiangtan first people's Hospital, Xiangtan, Hunan China
| | - Guangzhou Liao
- Department of Cardiology, People's Hospital of Yizhang County, Yizhang Hunan, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Abstract
The global epidemic of hypertension is largely uncontrolled and hypertension remains the leading cause of noncommunicable disease deaths worldwide. Suboptimal adherence, which includes failure to initiate pharmacotherapy, to take medications as often as prescribed, and to persist on therapy long-term, is a well-recognized factor contributing to the poor control of blood pressure in hypertension. Several categories of factors including demographic, socioeconomic, concomitant medical-behavioral conditions, therapy-related, healthcare team and system-related factors, and patient factors are associated with nonadherence. Understanding the categories of factors contributing to nonadherence is useful in managing nonadherence. In patients at high risk for major adverse cardiovascular outcomes, electronic and biochemical monitoring are useful for detecting nonadherence and for improving adherence. Increasing the availability and affordability of these more precise measures of adherence represent a future opportunity to realize more of the proven benefits of evidence-based medications. In the absence of new antihypertensive drugs, it is important that healthcare providers focus their attention on how to do better with the drugs they have. This is the reason why recent guidelines have emphasize the important need to address drug adherence as a major issue in hypertension management.
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Affiliation(s)
- Michel Burnier
- From the Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (M.B.)
| | - Brent M Egan
- Department of Medicine, Care Coordination Institute, University of South Carolina School of Medicine, Greenville, SC (B.M.E.)
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Choi SW, Han SW, Ok JS, Yoo BS, Shin MS, Park SH, Ryu KH. A multicenter cohort study of primary hypertension in Korea: study design and interim analysis of the Korean registry of target organ damage in hypertension (KorHR). Clin Hypertens 2017; 23:16. [PMID: 28794898 PMCID: PMC5540578 DOI: 10.1186/s40885-017-0072-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients. METHOD This is a prospective, observational, multicenter cohort study in which 23 university hospitals participated. Since May 2013, we have enrolled 1,318 consecutive hypertensive patients without known cardiovascular disease who met the following inclusion criteria: 1) age older than 30 years and 2) the first visit to the participating hospitals was within the last 5 years. RESULTS The mean age was 52 ± 12 years; 62.1% were male, and 41.3% were incident hypertensives. Patients with diabetes mellitus accounted for 7.8% of the population and 43.8% had hyperlipidemia or were on statins at baseline. The mean office blood pressures were 152 ± 20/96 ± 14 mmHg for incident hypertensive patients and 129 ± 13/78 ± 10 mmHg for patients on treatment. Patients with electrocardiographic and echocardiographic left ventricular hypertrophy accounted for 18.9 and 25.6%, respectively. The mean brachial-ankle pulse wave velocity (PWV) was 1564 ± 293 m/s and 19.5% had PWV values of more than 1750 cm/s. Patients with microalbuminuria and chronic kidney disease accounted for 21 and 4%, respectively. The first prescribed class of antihypertensive medications was angiotensin converting enzyme inhibitors in 2.9%, angiotensin receptor blockers (ARBs) in 57.5%, diuretics in 7.6%, calcium channel blockers (CCBs) in 61.0%, beta blockers in 17.3%, and fixed dose combination pill in 27.8%. CONCLUSION Our interim analysis shows that subclinical target organ damage in hypertension is considerably present for incident or treated hypertensive patients. CCBs and ARBs were the most commonly prescribed classes of antihypertensive medications and fixed dose combination pills were actively used in Korea. TRIAL REGISTRATION NCT01861080. Registered 16 May 2013.
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Affiliation(s)
- Suk-Won Choi
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University, 7 Keunjaebong-Gil, Hwaseong, Gyeonggido 18450 South Korea
| | - Seong Woo Han
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University, 7 Keunjaebong-Gil, Hwaseong, Gyeonggido 18450 South Korea
| | - Jong Sun Ok
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University, 7 Keunjaebong-Gil, Hwaseong, Gyeonggido 18450 South Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Sung Ha Park
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, South Korea
| | - Kyu-Hyung Ryu
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University, 7 Keunjaebong-Gil, Hwaseong, Gyeonggido 18450 South Korea
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Shin KE, Roh YK, Cho KH, Han KD, Park YG, Kim DH, Kim YH. The prevalence of hypertension in relation with the normal albuminuria range in type 2 diabetes mellitus within the South Korean population: The Korean National Health and Nutrition Examination Survey, 2011-2012. Prim Care Diabetes 2017; 11:281-287. [PMID: 28363425 DOI: 10.1016/j.pcd.2017.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 01/24/2017] [Accepted: 02/28/2017] [Indexed: 11/17/2022]
Abstract
AIMS The coexistence of hypertension (HTN) and diabetes mellitus (DM) increases the risk of cardiovascular disease. In some studies, normal albuminuria has also been associated with cardiovascular disease and HTN. Therefore, we examined the relationships between albuminuria and the prevalence of HTN and its control rate in type 2 DM patients. RESULTS We analyzed data from the 2011-2012 Korea National Health and Nutrition Examination Survey, and 1188 subjects with type 2 DM were included in the study. We divided albuminuria into 3 albuminuria tertiles (T): T1: <4.82mg/g; T2: 4.82-17.56mg/g; and T3: ≥17.56mg/g. The systolic and diastolic blood pressure were positively correlated with the albumin to creatinine ratio (ACR) after adjusting for all covariates (P<0.001). Type 2 DM subjects with hypertension had more ACR T3 (odds ratio=2.018, 95% confidence interval=1.445-2.818) than subjects without HTN. Subjects with controlled HTN had less ACR T3 than subjects without controlled HTN (odds ratio=0.566, 95% confidence interval=0.384-0.836). When, we redivided albuminuria by <10, 10-30 (high normal albuminuria), 30-300mg/g (microalbuminuria), and 300mg/g≤(macroalbuminuria), the odds ratio for high normal albuminuria and microalbuminuria was 1.52 and 2.24, respectively in the presence of HTN, however, high normal albuminuria was not associated with HTN control. CONCLUSIONS In conclusion, albuminuria within the high normal range was associated with the prevalence of HTN in South Korean patients with type 2 DM.
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Affiliation(s)
- Koh-Eun Shin
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Kyun Roh
- Department of Family Medicine, Hallym University College of Medicine, Chunchon, Republic of Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yong-Gyu Park
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Do-Hoon Kim
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yang-Hyun Kim
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea.
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Noh HM, Kim UY, Park YS, Song YR, Oh HY, Park KH, Paek YJ, Roh YK, Song HJ. Sex differences in the association between obesity and albuminuria among Korean adults: a cross-sectional study using the Korea National Health and Nutrition Examination Survey data. Clin Exp Nephrol 2016; 21:27-34. [PMID: 26902522 PMCID: PMC5283500 DOI: 10.1007/s10157-016-1238-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
Background The association between obesity and albuminuria in the general population remains unclear. We aimed to identify the association between obesity and albuminuria as well as sex differences regarding the associations using several obesity indices, including waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHR). Methods This study included 3841 subjects (1730 males and 2111 females; age 20–80 years) who participated in the Fifth Korea National Health and Nutrition Examination Survey conducted in 2011. Subjects with hypertension, diabetes, renal failure, or a malignant tumor and those who were pregnant or menstruating were excluded. Albuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Anthropometric parameters were categorized into sex-specific quartiles. Logistic regression models were used to assess the associations between each anthropometric parameter and albuminuria. Results All of the obesity indices of the fourth quartile group of females showed a twofold higher risk for albuminuria than the second quartile group, and it was persistently significant after adjusting for age, smoking, and physical activity. After further adjustment for high blood pressure and impaired fasting glucose and triglyceride levels, WC and BMI of the fourth quartile group of females still showed a significantly higher risk for albuminuria than the second quartile group (odds ratios 1.96 and 2.24; 95 % confidence intervals 1.03–3.74 and 1.15–4.37). None of the associations between albuminuria and the obesity indices were significant in males. Conclusion Higher WC and BMI were significantly associated with the risk of albuminuria among females, but not males. Electronic supplementary material The online version of this article (doi:10.1007/s10157-016-1238-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Un-Young Kim
- Daejeon Woori Spine Hospital, Daejeon, Republic of Korea
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Young Rim Song
- Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea
| | - Hye-Young Oh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
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11
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Jang M, Oh S, Noh HM, Chun S, Oh HY, Park KH, Paek YJ, Song HJ. Differences in Factors Associated with Albuminuria according to Gender and Comorbidities of Hypertension and Diabetes. Korean J Fam Med 2015; 36:316-22. [PMID: 26634099 PMCID: PMC4666868 DOI: 10.4082/kjfm.2015.36.6.316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/07/2015] [Accepted: 09/11/2015] [Indexed: 11/23/2022] Open
Abstract
Background This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM). Methods We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables. Results The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR. Conclusion The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.
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Affiliation(s)
- Miae Jang
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sunyoung Chun
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hye Young Oh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yu Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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12
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Lee S, Kim DH, Nam HY, Roh YK, Ju SY, Yoon YJ, Nam GE, Choi JS, Lee JE, Sang JE, Han K, Park YG. Serum Gamma-Glutamyltransferase Levels are Associated With Concomitant Cardiovascular Risk Factors in Korean Hypertensive Patients: A Nationwide Population-Based Study. Medicine (Baltimore) 2015; 94:e2171. [PMID: 26683926 PMCID: PMC5058898 DOI: 10.1097/md.0000000000002171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Previous studies suggested that serum gamma-glutamyltransferase (GGT) levels were associated with the prevalence of cardiovascular disease (CVD) risk factors including hypertension, diabetes mellitus (DM), and metabolic syndrome (MetS) in the general population. We aimed to investigate the relationship between serum GGT levels and CVD risk factors in Korean hypertensive patients. This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2011 to 2012. The analysis included 1541 hypertensive participants. Study participants were divided into groups according to tertiles of serum GGT with cutoff points of 20 and 35 U/L. Serum GGT levels were positively associated with the components of MetS (P value < 0.05, except for systolic blood pressure and high-density lipoprotein cholesterol). After adjusting for possible confounders, serum GGT levels were associated with an increased risk of MetS, high waist circumference, high triglyceride level, fasting plasma glucose, DM, and the urinary albumin-to-creatinine ratio (P = 0.001). In hypertensive patients, serum GGT levels are positively associated with major cardiovascular risk factors such as MetS, DM, and urinary albumin excretion.
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Affiliation(s)
- Sangsu Lee
- From the Department of Family Medicine, Korea University, College of Medicine, Seoul (SL, DHK, HYN, Y-JY, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (Y-KR); Department of Family Medicine, Catholic University, College of Medicine (S-YJ); Department of Biostatistics, Catholic University, College of Medicine, Seoul, Republic of Korea (KDH, Y-GP)
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Liu X, Liu Y, Chen Y, Li Y, Shao X, Liang Y, Li B, Holthöfer H, Zhang G, Zou H. Body mass index (BMI) is associated with microalbuminuria in Chinese hypertensive patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1998-2008. [PMID: 25674785 PMCID: PMC4344706 DOI: 10.3390/ijerph120201998] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/30/2015] [Indexed: 11/16/2022]
Abstract
There is no general consensus on possible factors associated with microalbuminuria in hypertensive patients nor any reported study about this issue in Chinese patients. To examine this issues, 944 hypertensive patients were enrolled in a study based on a cross-sectional survey conducted in Southern China. Multivariate regression analyses were performed to identify the factors related with the presence of microalbuminuria and urinary excretion of albumin. The prevalence of microalbuminuria in hypertensive and non-diabetic hypertensive patients were 17.16% and 15.25%, respectively. Body mass index (BMI), but not waist circumference (WC), were independently associated with microalbuminuria and the values of urinary albumin to creatinine ratio (ACR) based on multiple regression analyses, even after excluding diabetic patients and patients taking inhibitors of the renin-angiotensin system from the analyses. Furthermore, patients with obesity (BMI ≥28) had higher levels of ACR, compared with those with normal weight (BMI <24 kg/m2) and overweight (24 kg/m2≤ BMI < 28). In conclusion, BMI, as a modifiable factor, is closely associated with microalbuminuria among Chinese hypertensive patients, which may provide a basis for future development of intervention approaches for these patients.
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Affiliation(s)
- Xinyu Liu
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Yu Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China.
- Department of Statistics, School of Mathematics and Computational Science, Sun Yat-Sen University, Guangzhou 510275, China.
| | - Youming Chen
- Clinical Laboratory Centre, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Yongqiang Li
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Xiaofei Shao
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Yan Liang
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Bin Li
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Harry Holthöfer
- Centre for Bio Analytical Sciences (CBAS), Dublin City University, Dublin 9, Ireland.
| | - Guanjing Zhang
- Techco Information Technologies Co., Ltd., Shenzhen 518057, China.
| | - Hequn Zou
- Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
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Yoon SJ, Kim DH, Nam GE, Yoon YJ, Han KD, Jung DW, Park SW, Kim YE, Lee SH, Lee SS, Kim YH. Prevalence and control of hypertension and albuminuria in South Korea: focus on obesity and abdominal obesity in the Korean National Health and Nutrition Examination Survey, 2011-2012. PLoS One 2014; 9:e111179. [PMID: 25360593 PMCID: PMC4215993 DOI: 10.1371/journal.pone.0111179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 09/24/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Albuminuria is associated with cardiovascular disease, and the relationship between albuminuria and hypertension is well established in many studies. So the control of hypertension is critical for decreasing cardiovascular events and albuminuria. Obesity and abdominal obesity are also associated with hypertension and albuminuria. Therefore, we analyzed the relationship between albuminuria and the prevalence and control of hypertension in the general Korean population according to obesity status. METHODS We analyzed data from the 2011-2012 Korea National Health and Nutrition Examination Survey, and 9,519 subjects were included. Subjects were divided into four groups: non-obese/normal waist circumference, non-obese/high waist circumference, obese/normal waist circumference, and obese/high waist circumference. RESULTS Systolic blood pressure and diastolic blood pressure were positively associated with albumin-creatinine ratio in all groups (all p values <0.005). Non-obese/normal waist circumference group were more likely to have hypertension (odds ratios [95% confidential intervals (CIs)] were 3.20 [2.21-4.63] in microalbuminuria level and 3.09 [1.05-9.14] in macroalbuminuria level), and less likely to have controlled hypertension (odds ratios <1 for both albuminuria levels) after adjusting for all covariates. Obese/normal waist circumference group were also more likely to have hypertension (odds ratio [95% CI] were 3.10 [1.56-6.15] in microalbuminuria level and 21.75 [3.66-129.04] in macroalbuminuria level), and less likely to have controlled hypertension in macroalbuminuria level (odds ratio [95% CI], 0.04 [0.01-0.15]). CONCLUSIONS Non-obese and normal waist circumference subjects have an increased prevalence and decreased control of hypertension in microalbuminuria and macroalbuminuria levels. Screening for albuminuria may provide helpful information about hypertension and blood pressure control, particularly in the non-obese and normal waist circumference subjects.
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Affiliation(s)
- Su-Jung Yoon
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ga-Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeo-Joon Yoon
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Dong-Wook Jung
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Woon Park
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Young-Eun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sung-Ho Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Su Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
- * E-mail:
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15
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Nagasawa Y, Hasuike Y, Nanami M, Kuragano T, Nakanishi T. Albuminuria and hypertension: the chicken or the egg? Hypertens Res 2014; 38:8-10. [PMID: 25185833 DOI: 10.1038/hr.2014.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasuyuki Nagasawa
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan
| | - Yukiko Hasuike
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan
| | - Masayoshi Nanami
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan
| | - Takahiro Kuragano
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan
| | - Takeshi Nakanishi
- Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan
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16
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Murai S, Tanaka S, Dohi Y, Kimura G, Ohte N. The prevalence, characteristics, and clinical significance of abnormal albuminuria in patients with hypertension. Sci Rep 2014; 4:3884. [PMID: 24457614 PMCID: PMC3900920 DOI: 10.1038/srep03884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 01/09/2014] [Indexed: 11/25/2022] Open
Abstract
Kidney function and cardiovascular disease are closely connected and albuminuria is a proven marker of cardiovascular risk. The present study investigated the prevalence and characteristics of albuminuria in patients with hypertension. Outpatients with essential hypertension under medical treatment were enrolled in this study (n = 350, 70.0 ± 11.4 years old). Urine samples were collected for the measurement of albumin concentration, which are expressed as the ratio of urine albumin to creatinine concentration (mg/g Cr). Cross-sectional analyses were also performed of the relationships between urinary albumin and other variables. Urinary albumin was detected in 88.3% of patients, while only 35.4% showed abnormal albuminuria (≥30 mg/g Cr). The presence of abnormal albuminuria was independently correlated with systolic blood pressure, B-type natriuretic peptide, and C-reactive protein by multivariate analysis (P < 0.05). Furthermore, multivariate regression analysis identified systolic blood pressure, serum creatinine, B-type natriuretic peptide, and C-reactive protein as the only factors showing independent correlation with urinary albumin (P < 0.05). Thus, approximately 35% of hypertensive patients had abnormal albuminuria. Urinary albumin was closely associated with blood pressure, C-reactive protein, and B-type natriuretic peptide, indicating that the severity of albuminuria parallels that of systemic inflammation, cardiac load, and blood pressure.
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Affiliation(s)
- Shunsuke Murai
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoru Tanaka
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuaki Dohi
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Nobuyuki Ohte
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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