Body Mass Index or Microalbuminuria, Which One is More Important for the Prediction and Prevention of Diastolic Dysfunction in Non diabetic Hypertensive Patients?

Abstract

Background: Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained ― ‘Which is more important for the prediction and prevention of diastolic dysfunction in non‑diabetic hypertensive patients?’

Methods: The current study was a cross‑section study conducted on a total of 126 non‑diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two‑dimensional, doppler, and tissue‑doppler echocardiography was performed and the recording of the diastolic function parameters was carried out.

Results: High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter.

Conclusion: According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non‑diabetic hypertensive patients.

Keywords: Hypertension, microalbuminuria, heart failure, obesity