• Hiroyuki Takase, Tomonori Sugiura, Nobuyuki Ohte, and Yasuaki Dohi.
• From the Department of Internal Medicine (HT), Enshu Hospital, Hamamatsu; and Department of Cardio-Renal Medicine and Hypertension (TS, NO, YD), Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
• Medicine (Baltimore). 2015 Feb 1; 94 (6): e511e511.

AbstractWe investigated whether urinary albumin could predict the development of hypertension and future increases in blood pressure in the normotensive general population.Normotensive subjects who visited our hospital for a physical checkup (n = 6205, men 61.8%, 53.4 ± 11.4 years old) were enrolled in this study. Urine samples were collected for the measurement of albumin concentration, expressed as the ratio of urinary albumin to creatinine concentrations (UACR [mg/g Cr]). After the baseline examination, subjects were followed up for a median of 1089 days with the endpoint being the development of hypertension.Urinary albumin was in the normal range (UACR <30 mg/g Cr) in most subjects (97.5%). During the follow-up, hypertension developed in 1184 subjects (19.1%, 69.5 per 1000 person-years), with more men than women affected. The incidence of hypertension was increased across the quartiles of UACR by Kaplan-Meier analysis (log-rank, P < 0.0001) and the hazard ratio (lowest quartile [median UACR 1.14 mg/g Cr] as reference) was 1.53 (95% confidence intervals 1.30-1.80) in the highest quartile (median UACR 8.87 mg/g Cr). Multivariate Cox hazard analysis in which UACR was taken as a continuous variable identified UACR as a significant predictor of hypertension (hazard ratio 1.37, 95% CI 1.20-1.56). UACR was also an independent predictor of future increases in systolic blood pressure (P < 0.01).Urinary albumin is an independent predictor of hypertension and increases in blood pressure in the general population even in the normal range below the threshold defined for microalbuminuria.

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