Acute and long-term effect of antihypertensive treatment on exercise induced microalbuminuria in essential hypertension.

The effects of mild to moderate exercise (450 kpm/min followed by 600 kpm/min, 20 minutes each) on urinary albumin excretion (UAE) were studied with a group of 12 young patients with newly diagnosed essential hypertension. The mean age was 37 years (range 22-45 years) and mean weight 82 kg. During exercise UAE increased significantly from 12.1 microg/min to 16.7 microg/min. Six of the twelve patients were investigated in an acute study with two exercise tests with minimum one week between one of the times metoprolol was given intravenously and the other time was given placebo. In spite of an effective reduction in systolic blood pressure (in mean 23 mmHg during the maximal workload at 600 kpm/min) no significant difference could be seen in UAE. However, a marked decrease in UAE in six patients treated with beta-blocker in a long-term study was seen. Six months after initiating antihypertensive treatment, the baseline systolic blood pressure was reduced by 38 mmHg and UAE by 63%. The maximal exercise induced increased systolic blood pressure level at 600 kpm/min was reduced by 58 mmHg and UAE by 58%. We conclude that UAE both at rest and during exercise may be a sensitive marker of the effectiveness of antihypertensive therapy. UAE is easy to measure and this parameter might be useful in following essential hypertensive patients.