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

Abstract

Background: Increased 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. Design: Cardiac 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. Results: Mean LVM was 121 g for men (SD 26) and 87 g for women (SD 20). Mean eGFR was 82 mL/min/1·73 m² (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 10 mL/min/1·73 m² change in eGFR 0·79 g, 95% CI -0·33 to 1·91, P = 0·17, mean change in LVM in presence vs. absence of albuminuria 9·9 g, 95% CI 4·33 to 15·45, P = 0·001). Additional adjustment for systolic blood pressure did not change results (B for eGFR 0·54, 95% CI -0·58 to 1·66, P = 0·35, B for albuminuria 9·09, 95% CI 3·57 to 14·60, P = 0·001). Conclusions: In this study in hypertensive patients with high vascular risk, albuminuria was related to increased LVM and eGFR was not.