Microalbuminuria and left ventricular hypertrophy among newly diagnosed black African hypertensive patients: a cross sectional study from a tertiary hospital in Uganda.
Microalbuminuria and left ventricular hypertrophy among newly diagnosed black African hypertensive patients: a cross sectional study from a tertiary hospital in Uganda.
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DOI：
10.1186/s13104-015-1156-2
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发表时间：
2015-05-14
影响因子：
1.8
通讯作者：
Kalyesubula R
中科院分区：
文献类型：
--
作者：
Nabbaale J;Kibirige D;Ssekasanvu E;Sebatta ES;Kayima J;Lwabi P;Kalyesubula R
微量白蛋白尿是肾损害的早期表现，并独立预测心血管疾病（CVD）。左心室肥厚（LVH）也是高血压患者靶器官损害的早期心脏表现。在非洲成人高血压人群中，微量白蛋白尿的预后意义及其与左心室肥厚的相关性尚未得到广泛研究。本研究旨在确定微量白蛋白尿的患病率、微量白蛋白尿患者的LVH以及在乌干达坎帕拉的Mulago国家转诊和教学医院和乌干达心脏研究所的大型高血压门诊或心脏科病房新诊断的黑人成人高血压患者中微量白蛋白尿与LVH之间的相关性。在这项横断面研究中，256名新诊断的符合条件的黑人成年高血压患者参加了门诊高血压诊所或在Mulago国家转诊和教学医院和乌干达心脏研究所（坎帕拉乌干达）的心脏科病房住院，连续招募了5个月。使用预先测试的问卷收集研究参与者的社会人口统计学、临床和实验室结果的数据。采集两份点尿样本以评估微量白蛋白尿。超声心动图（ECHO）采用Teicholz公式评估左心室质量指数作为早期高血压心脏病的证据。研究参与者的平均年龄/标准差为54.3 ± 6.2岁，女性占多数（162，63.3%）。新诊断高血压患者中微量白蛋白尿的患病率为39.5%。微量白蛋白尿患者中左室肥厚的患病率为17%。在Mulago医院新诊断的成人高血压患者中，微量白蛋白尿与左心室肥厚呈正相关（r = 0.185，p = 0.003）。这项研究表明，微量白蛋白尿是高度流行的新诊断的黑人高血压患者和左室肥厚的存在。在新诊断的高血压患者中，微量白蛋白尿与LVH也呈正相关。由于它是一种成本较低且容易获得的测试，因此它可用于预测LVH的存在，特别是在ECHO服务不容易获得的资源有限的环境中。
Microalbuminuria is an early manifestation of kidney damage and independently predicts cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) is also an early marker of cardiac manifestation of target organ damage among hypertensive patients. The prognostic significance of microalbuminuria and its correlation with left ventricular hypertrophy has not been extensively studied in African adult hypertensive populations. This study aimed at determining the prevalence of microalbuminuria, LVH in patients with microalbuminuria and the correlation between microalbuminuria and LVH among newly diagnosed black adult hypertensive patients attending a large outpatient hypertension clinic or admitted on the cardiology ward at Mulago national referral and teaching hospital and Uganda Heart Institute in Kampala, Uganda. In this cross-sectional study, 256 newly diagnosed eligible black adult hypertensive patients attending the outpatient hypertension clinic or admitted on the cardiology ward at Mulago national referral and teaching hospital and the Uganda Heart Institute, Kampala Uganda were consecutively recruited over a period of 5 months. Data on socio-demographics, clinical and laboratory findings of the study participants was collected using a pre tested questionnaire. Two spot urine samples were collected to assess for microalbuminuria. Echocardiography (ECHO) was done to assess for the left ventricular mass index using the formula of Teicholz as evidence for early hypertensive heart disease. The mean age/standard deviation of the study participants was 54.3 ± 6.2 years with a female predominance (162, 63.3 %). The prevalence of microalbuminuria among newly diagnosed hypertensive patients was 39.5 %. The prevalence of LVH among patients with microalbuminuria was found to be 17 %. There was a positive correlation between microalbuminuria and left ventricular hypertrophy among the newly diagnosed adult hypertensive patients at Mulago Hospital (r = 0.185, p = 0.003). This study demonstrates that microalbuminuria is highly prevalent among newly diagnosed black hypertensive patients and in the presence of LVH. There is also a positive correlation between microalbuminuria and LVH among newly diagnosed hypertensive patients. Since it is a less costly and readily available test, it can be used to predict presence of LVH especially in resource limited settings where ECHO services are not readily available.