Presence of albuminuria predicts left ventricular mass in patients with chronic systemic arterial hypertension.

BackgroundIncreased left ventricular mass (LVM) is known to predict cardiovascular morbidity and mortality. LVM is high in patients with advanced kidney disease. Our aim was to study the relationship between renal parameters and LVM in hypertensive subjects at high risk of cardiovascular disease. DesignCardiac MRI was performed in 527 patients participating in the single-centre SMART cohort study. Participants free from previous symptomatic coronary heart disease but with a history of hypertension were recruited. Subjects were screened for cardiovascular risk factors in a standardized way. Multivariable linear regression was used to study the relationship of both estimated glomerular filtration rate (eGFR) and presence of albuminuria with left ventricular mass. ResultsMean LVM was 121g for men (SD 26) and 87g for women (SD 20). Mean eGFR was 82mL/min/173m(2) (SD 19). A total of 73 patients (14%) had albuminuria. After adjusting for known determinants of LVM (height, weight, sex and age) eGFR did not relate to LVM while presence of albuminuria did (mean change in LVM per 10mL/min/173m(2) change in eGFR 079g, 95% CI -033 to 191, P=017, mean change in LVM in presence vs. absence of albuminuria 99g, 95% CI 433 to 1545, P=0001). Additional adjustment for systolic blood pressure did not change results (B for eGFR 054, 95% CI -058 to 166, P=035, B for albuminuria 909, 95% CI 357 to 1460, P=0001). ConclusionsIn this study in hypertensive patients with high vascular risk, albuminuria was related to increased LVM and eGFR was not.