Microalbuminuria is independently associated with ischaemic electrocardiographic abnormalities in a large non-diabetic population. The PREVEND (Prevention of REnal and Vascular ENdstage Disease) study

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Abstract
Aim To assess the value of microalbuminuria as an indicator of increased cardiovascular risk in a non-diabetic population. Methods and Results 7579 non-diabetic subjects were studied with ages ranging from 28 to 75 years selected from a population based cohort. Using computerized Minnesota coding, ischaemic electrocardiographic abnormalities were divided into three categories: infarct patterns, major ischaemia, and minor ischaemia. Urinary albumin excretion was measured as the mean of two 24-h urine collections. Cardiovascular risk indicators were defined as an age above 60 years, male sex, hypertension, hypercholesterolaemia, smoking, obesity and a positive cardiovascular family history. Microalbuminuria was associated with age, sex, blood pressure, serum cholesterol, serum glucose, body mass index and all three categories of electrocardiographic abnormalities. In a multivariate model, adjusted for established cardiovascular risk indicators, microalbuminuria was independently associated with infarct patterns (OR [95% CI] 1·61 [1·12–2·32]), major ischaemia (OR 1·43 [1·08–1·91]) and minor ischaemia (OR 1·32 [1·03–1·68]). Conclusions The independent association between microalbuminuria and ischaemic electrocardiographic abnormalities suggests that microalbuminuria has additional value to conventional risk indicators in predicting cardiovascular disease in non-diabetics. Assessment of microalbuminuria could be an instrument to identify those at an increased risk for coronary vascular disease in an early stage.

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