Evaluation of subclinical organ damage for risk assessment and treatment in the hypertensive patient: Role of microalbuminuria
Evaluation of subclinical organ damage for risk assessment and treatment in the hypertensive patient: Role of microalbuminuria
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DOI：
10.1681/asn.2005121327
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发表时间：
2006-04-01
影响因子：
13.6
通讯作者：
Deferrari, Giacomo
中科院分区：
文献类型：
--
作者：
Pontremoli, Roberto;Leoncini, Giovanna;Deferrari, Giacomo
微量白蛋白尿，即尿中白蛋白排泄异常，可通过低成本且广泛使用的检测方法检测到，是识别心血管 (CV) 风险较高的高血压患者的一线工具。大量研究提供的证据表明，微量白蛋白尿是心脏和血管损伤的伴随因素，也是心血管事件的强大、独立的预测因子。一个重要的、新出现的问题是，心血管发病率和死亡率的风险与尿白蛋白排泄量呈线性相关，并且持续远低于目前用于定义微量白蛋白尿的临界值。此外，最新证据表明，抗高血压治疗下白蛋白尿的减少与心血管风险的变化同时发生。通过微量白蛋白尿常规寻找靶器官损伤可能会显着改善原发性高血压患者的评估和治疗。
Microalbuminuria, i.e., abnormal urinary excretion of albumin, which is detectable by low cost and widely available tests, is a first-line tool for identifying hypertensive patients who are at higher cardiovascular (CV) risk. Numerous studies have provided evidence that microalbuminuria is a concomitant of cardiac and vascular damage as well as a strong, independent predictor of CV events. An important, emerging issue is that the risk for CV morbidity and mortality is linearly related to urinary albumin excretion and persists well below the currently used cutoff for defining microalbuminuria. Furthermore, late-breaking evidence suggests that a reduction of albuminuria under antihypertensive treatment is paralleled by changes in CV risk. The routine search for target organ damage by means of microalbuminuria could lead to a significant improvement in the evaluation and treatment of patients with primary hypertension.