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Blood pressure, atherosclerosis, and albuminuria in 10,113 participants in the atherosclerosis risk in communities study.

TitleBlood pressure, atherosclerosis, and albuminuria in 10,113 participants in the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2009
AuthorsHsu CC, Brancati FL, Astor BC, Kao WHong, Steffes MW, Folsom AR, Coresh J
JournalJ Hypertens
Volume27
Issue2
Pagination397-409
Date Published2009 Feb
ISSN0263-6352
KeywordsAlbuminuria, Atherosclerosis, Blood Pressure, Comorbidity, Creatinine, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, United States
Abstract

BACKGROUND: Albuminuria predicts cardiovascular risk, but its function as a marker of endothelial damage and atherosclerosis is uncertain, as is the complex relationship with hypertension and diabetes.

OBJECTIVE: To determine whether hypertension contributes to albuminuria across levels of atherosclerosis and type 2 diabetes.

METHODS: Cross-sectional associations of cardiovascular risk factors and albuminuria were examined in 10,113 middle-aged participants in the atherosclerosis risk in communities study divided into four subgroups: type 2 diabetes with marked atherosclerosis, type 2 diabetes without marked atherosclerosis, without diabetes with marked atherosclerosis, and without diabetes without marked atherosclerosis. Marked atherosclerosis was defined as high levels of carotid atherosclerosis or prevalent coronary heart disease.

RESULTS: Hyperglycemia and hypertriglyceridemia were associated with albuminuria, but only among patients with type 2 diabetes. In multivariate models, increasing blood pressure levels (but not albuminuria) were significantly associated (P-trend

CONCLUSION: Blood pressure, even at high-normal levels, is consistently associated with albuminuria across categories of type 2 diabetes and atherosclerosis. Our results suggest that the effects of blood pressure on albuminuria are not solely mediated through generalized vascular damage, as represented by degree of atherosclerosis.

DOI10.1097/hjh.0b013e32831aede6
Alternate JournalJ Hypertens
PubMed ID19226709
PubMed Central IDPMC2792744
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
R01 DK076770 / DK / NIDDK NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01 HC055020 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States