Relation of urinary albumin excretion to coronary heart disease and low renal function: Role of blood pressure

Relation of urinary albumin excretion to coronary heart disease and low renal function: Role of blood pressure. Background Previous studies report that urinary albumin excretion is associated with coronary heart disease (CHD). The present epidemiologic study investigated if ( 1 ) blood pressure status affects the association of urinary albumin excretion with CHD; and ( 2 ) urinary albumin excretion is associated with low renal function also. Methods The cross-sectional association was analyzed of overnight urinary albumin excretion with prevalence of CHD (myocardial infarction and/or ischemia as defined by standard electrocardiogram) and low renal function (overnight creatinine clearance Results CHD prevalence was in the whole sample 8.2% ( N = 134), in the hypertensive subgroup 11.9% ( N = 79), and in the nonhypertensive subgroup 5.7% ( N = 55). For the association between urinary albumin excretion (logarithm-transformed due to skewed distribution) and CHD, the multivariate logistic coefficient with 95% CI was significant in the whole sample (+0.79, 95% CI=+0.32/+1.26, P P P = 0.997). Prevalence of low creatinine clearance was in the whole sample 4.0% ( N = 66), in the hypertensive subgroup 4.8% ( N = 32), and in the nonhypertensive subgroup 3.5% ( N = 34). The logistic coefficient between urinary albumin excretion and low creatinine clearance was borderline significant in the whole sample (+0.56, 95% CI=-0.02/+1.14, P = 0.090), significant in the hypertensive subgroup (+0.73, 95% CI=+0.04/+1.42, P = 0.044), not significant in the nonhypertensive subgroup (-0.07, 95% CI=-1.25/+1.10, P = 0.913). Conclusion Results support the use of urinary albumin excretion as marker of CHD and slightly reduced renal function in hypertensives.