gms | German Medical Science

Microalbuminuria (MAU) is a first sign for renal organ damage in hypertension. A consequent antihypertensive therapy may positively influence an existing MAU or even reverse it completely. Possible relationships to blood pressure and cardiovascular (cv) changes have been reported. In addition, a correlation between blood pressure and MAU is known for the ambulatory 24h blood pressure measurement (ABPM).

1. To determine the frequency of MAU.

2. Evaluation of an ACE-inhibitor (ramipril) therapy on blood pressure, the incidence or conversion of MAU and concomitant cv diseases in non-diabetic patients with hypertension.

3. Evaluation if normalization of MAU leads to decrease of cv events.

Prospective, controlled, open multi-centre project. Non-diabetic patients with hypertension without known renal diseases between 50 and 80 years not previously been treated with ramipril before were to be included when medical practitioner decided to start treatment with ramipril. ABPM and proteinuria-analysis was performed once a year up to 5 years. Determination of albumin-, total protein- and alpha1-microglobulin-excretion was carried out by quantitative protein measurement (nephelometry) in central laboratory of St.-Josefs-Hospital, Cloppenburg. Additionally SDS-electrophoresis was performed.

4654 patients had been screened. About 75% of them were documented in long-term follow up (mean 3.5 years). In 51.5%, no proteinuria was observed, 33% were showing MAU. Signs of tubular damage occurred in 12.1%, and 3.4% of all patients revealed selective- or unselective-glomerular proteinuria.

Final results will be presented concerning blood pressure, cardiovascular events and outcome comparing patients with and without MAU.