Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(6), 622–631. https://doi.org/10.1002/clc.24012 Li Ming et al.
Points
- Subtle increases in urine albumin-to-creatinine ratio (uACR) within the normal range are associated with a higher prevalence of hypertension in the general population of the United States.
- Each 5 mg/g increment in uACR results in a 1.31-fold increase in hypertension prevalence, indicating a significant association between uACR and hypertension.
- Individuals in the highest uACR quartile have 2.25 times higher odds of experiencing hypertension than those in the lowest.
- The relationship between uACR and hypertension prevalence exhibits a nonlinear pattern, further highlighting the significance of uACR as a potential risk factor for hypertension.
- The association between uACR and hypertension prevalence is particularly strong in individuals with lower body mass index (BMI), emphasizing the importance of considering BMI when assessing the impact of uACR on hypertension.
Summary
This research paper investigates the potential link between urine albumin-to-creatinine ratio (uACR) within the normal range and the prevalence of hypertension. Utilizing data from the National Health and Nutrition Examination Survey conducted between 2009 and 2018, encompassing 14,919 participants, the study aimed to determine the association between uACR and hypertension prevalence. Hypertension was defined as mean systolic blood pressure ≥130 mmHg, mean diastolic blood pressure ≥80 mmHg, the use of hypertension medication, or a physician/health professional diagnosis.
Multivariable-adjusted models revealed a significant association between uACR and hypertension prevalence. With each 5 mg/g increase in uACR, the prevalence of hypertension increased by 1.31-fold (OR, 1.31; 95% CI 1.23–1.40). Furthermore, individuals in the highest uACR quartile had 2.25 times higher odds (95% CI 1.86–2.72) of experiencing hypertension compared to those in the lowest quartile. As visually assessed, the relationship between hypertension prevalence and uACR demonstrated a nonlinear pattern, indicating a significant association (p for nonlinearity<.001). Subgroup analysis stratified by body mass index (BMI) indicated a stronger association between uACR and hypertension prevalence in individuals with lower BMI.
In conclusion, this study underscores the importance of monitoring uACR even within the normal range, as subtle elevations were associated with an increased prevalence of hypertension in the general population of the United States. Moreover, the findings suggest that the association may be particularly pronounced among individuals with low BMI. Further research is necessary to determine the clinical implications of these findings and their potential applicability in clinical practice.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24012
References Ming, L., Wang, D., & Zhu, Y. (2023). Association between urinary albumin‐to‐creatinine ratio within normal range and hypertension among adults in the United States: Data from the NHANES 2009–2018. Clinical Cardiology, 46(6), 622–631. https://doi.org/10.1002/clc.24012
