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Microalbuminuria in primary hypertension: a guide to optimal patient management?

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Abstract

Accurate assessment of the global risk profile is considered a prerequisite for the optimal management of hypertensive patients. In particular, the evaluation of subclinical organ damage, namely left ventricular hypertrophy, peripheral atherosclerosis and renal function, plays a key role in optimizing therapeutic targets and strategy in individual patients. Urine albumin excretion is a low-cost, easy-to-use test and a powerful predictor of cardiovascular diseases. The search for albuminuria has, therefore, become routine in the evaluation of hypertensive patients. Moreover, albuminuria has been shown to be associated with early signs of extra-renal organ damage such as left ventricular hypertrophy, and carotid atherosclerosis. Under effective antihypertensive treatment, changes in subclinical organ damage over time, especially regression of left ventricular hypertrophy, are paralleled by modification of risk status and may serve as intermediate endpoints for treatment. More recently, changes in albuminuria have also been proposed to reflect changes in the risk of cardiovascular events. If this is confirmed by large well-designed studies, microalbuminuria may not simply be regarded as a risk predictor but become itself an independent target for treatment.

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  1. Università degli Studi di Genova and IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, Genoa, Italy

    Francesca Viazzi, Francesca Cappadona & Roberto Pontremoli

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  1. Francesca Viazzi
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Correspondence to Roberto Pontremoli.

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Viazzi, F., Cappadona, F. & Pontremoli, R. Microalbuminuria in primary hypertension: a guide to optimal patient management?. J Nephrol 29, 747–753 (2016). https://doi.org/10.1007/s40620-016-0335-0

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