An effective indicator in predicting cardiovascular events: urine albumin to creatinine ratio

H. Zhao, Y.-F. Jiang, X.-C. Zhou, L. Yao, J. Chen, D. Wang, D.-Y. Fu

Department of Emergency, Shanghai TCM – Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. fdy65@126.com

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• Cardiology

OBJECTIVE: To study elderly hypertensive patients with trace albuminuria (urine albumin to creatinine ratio (UACR)) and the relationship between the occurrence of new cardiovascular events, to provide a basis for early prevention in elderly patients with high blood pressure.

PATIENTS AND METHODS: A total of 3564 elderly patients with high blood pressure were enrolled in the study. Based on UACR, patients were divided into four groups (group A: 0.05-3.20 mg/g; group B:3.21-10.04 mg/g; group C: 10.05-19.33 and group D: 19.34-30.00 mg/g). All patients underwent follow-up for an average period of 3.8 years. Four groups were compared for new cardiovascular events and they were correlated with UACR.

RESULTS: Through multivariate Cox proportional hazards regression analysis, the relative risk of cardiocerebrovascular events, cerebral infarction, and acute myocardial infarction (mi), in group D was 1.74 times (p < 0.05), 1.66 times (p < 0.05), and 2.48 times (p < 0.05), respectively. UACR level in females and those with higher age, body mass index, systolic blood pressure, fasting blood glucose, TG, TC, LDL-C levels and lower HDL-C were higher. During follow-up, patients from group D with sudden cardiac death, acute myocardial infarction, cerebral hemorrhage, cerebral infarction occurrence was significantly higher than group A (χ2 = 79.3, p = 79.3)

CONCLUSIONS: According to UACR level, we can perform early prevention for elderly patients with high blood pressure, thus reducing the occurrence of cerebral infarction and myocardial infarction.

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