Leoncini G, Ratto E, Viazzi F, Pontremoli R
Dipartimento Cardionefrologico, Azienda Ospedaliera-Universitaria San Martino, Genova, Italy.
G Ital Nefrol. 2007 Nov-Dec;24(6):565-73.
The cost-effectiveness of antihypertensive treatment increases in parallel with the global burden of risk in the individual patient. Therefore, there has been growing interest in developing sensitive and easy-to-perform clinical tools to accurately and inexpensively identify patients at high cardiovascular risk. Over the past several years a number of studies have provided evidence that microalbuminuria is an integrated marker of hypertensive organ damage and a strong, independent predictor of cardiovascular and cerebrovascular events. Recent data indicate that the risk is linearly related to the degree of urinary albumin excretion, with no identifiable threshold or plateau. Furthermore, changes in urinary albumin excretion parallel changes in risk. We propose the routine search for microalbuminuria in order to optimize cost-effectiveness in the diagnostic approach to patients with primary hypertension.
