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Association between undiagnosed hypertension and microalbuminuria in South Asians without known diabetes

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Abstract

Data suggest increased rates of chronic kidney disease (CKD) in those with undiagnosed hypertension (HTN). Our study aimed to determine the prevalence of CKD in undiagnosed hypertensives in a previously unreported subgroup of individuals of South Asian ethnicity. We analysed data from subjects in the ADDITION-Leicester study, a UK based multiethnic, community diabetes screening study. Standard definitions included: HTN—mean recorded BP of ⩾140/90 mm Hg, CKD stage 3 and above—estimated glomerular filtration rate (eGFR) <60 ml min−1 per 1.73 m2 and microalbuminuria as albumin creatinine ratio ⩾3 mg mmol−1. Logistic regression was performed with age, gender and body mass index (kg m−2) as co-variates. 6082 individuals (52.5% female, mean age, 57.2 years; White European, 77.8% and South Asian, 22.0%), 31.1% had undiagnosed HTN. Overall, individuals with undiagnosed HTN compared with normotensives had an odds ratio for microalbuminuria of 2.24 (95% confidence interval (CI): 1.72–2.94). For South Asians, the odds ratio was 3.81. (95% CI: 2.24–6.47) for microalbuminuria with a trend towards an eGFR<60 ml min−1 per 1.73 m2. Future studies should consider intensified screening for HTN to refine the population suitable for CKD screening, particularly in the South Asian ethnic group.

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Acknowledgements

We thank the ADDITION-Leicester screening team and all the primary care practices that took part in the study.

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Authors and Affiliations

  1. Department of Health Sciences, University of Leicester, Leicester, UK

    RW Major, LJ Gray & K Khunti

  2. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

    MJ Davies & DR Webb

  3. Department of Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK

    W Crasto

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  1. RW Major
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  2. MJ Davies
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  3. W Crasto
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  4. LJ Gray
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  5. DR Webb
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Correspondence to DR Webb.

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Competing interests

Davies MJ—has acted as a consultant, advisory board member and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme and Roche, and as a speaker for Servier. She has received grants in support of investigator and investigator initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Merck Sharp & Dohme, GlaxoSmithKline and Servier. Webb DR—Novo Nordisk Research Foundation. Khunti K—has acted as a consultant and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly and Merck Sharp & Dohme. He has received grants in support of investigator and investigator initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim and Merck Sharp & Dohme. The rest of the authors declare no conflict of interest.

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Major, R., Davies, M., Crasto, W. et al. Association between undiagnosed hypertension and microalbuminuria in South Asians without known diabetes. J Hum Hypertens 29, 185–189 (2015). https://doi.org/10.1038/jhh.2014.62

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  • DOI: https://doi.org/10.1038/jhh.2014.62

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