Relation of Albuminuria to Left Ventricular Mass (from the HyperGEN Study)

Although albuminuria has been associated with a larger left ventricular (LV) mass in hypertensive and diabetic populations, little is known about this association in normotensive adults. We hypothesized that albuminuria is positively associated with LV mass in normotensive and hypertensive subjects. We analyzed data from 3,445 participants of the Hypertension Genetic Epidemiology Network (HyperGEN) Study (mean age 48.6 ± 13.7 years, range 18 to 87, 57% women). LV parameters were obtained by echocardiography. Urinary albumin was estimated using standard methods. From the lowest to highest quartile of albuminuria, multivariable adjusted means of LV mass indexed to body surface area were 71.9, 73.3, 74.0, and 76.5 g/m², respectively (p for trend = 0.002) in normotensive participants. Corresponding values for hypertensive subjects were 87.4, 89.3, 92.3, and 94.9 g/m², respectively (p for trend <0.0001). Similar results were observed for LV mass indexed to height^2.7. In secondary analyses, we found similar associations for men and women and after exclusion of subjects with diabetes. Furthermore, positive associations were observed between albuminuria and LV wall thickness in hypertensive and normotensive subjects. Albuminuria was negatively related to ejection fraction only in hypertensive subjects. In conclusion, these results suggest that albuminuria is positively associated with LV mass in normotensive subjects as it is in hypertensive subjects.