Does albuminuria correlate with silent myocardial ischemia and delayed heart rate recovery in hypertensive men without diabetes mellitus.

BACKGROUND

In diabetes patients, albuminuria has been proven to be an independent predictor for SMI and delayed heart rate recovery (HRR). However, in hypertensive patients without diabetes the correlation is still unclear.

AIM: To determine the correlation between albuminuria to SMI and delayed HRR in hypertensive patients without diabetes.

METHODS

Fourty consecutive asymptomatic primary hypertensive men, aged 40-60 years, without diabetes were included. They underwent treadmill stress testing (TST) and collection of spot urine to measure albumin urine to creatinine ratio (ACR). SMI and HRR at first, second, and third minute were then recorded. SMI was diagnosed if positive ischemic criteria of TST was met without anginal symptom. Albuminuria and delayed HRR were diagnosed based on the treshold value respectively.

RESULTS

SMI was diagnosed in 15 % patients. The prevalence of delayed HRR at the first-, second-, and third-minute after exercise were 60, 80, and 52.5 % respectively. Albuminuria was significantly associated with SMI [OR 13.889 (95 % CI 1.423-135.544), p = 0.014]. ROC curve analysis demonstrated the area under the curve (AUC) = 0.784 [(95 % CI 0.588-0.98), p = 0.028], with subsequent calculated sensitivity, specificity, positive- and negative-predictive value of albuminuria to predict SMI were 83.3, 73.5, 35.7, and 96.2 % respectively. Those were no significant correlation between albuminuria and delayed HRR at first, second, and third minute.

CONCLUSION

Albuminuria is a potential marker for excluding SMI in asymptomatic hypertensive men without diabetes.