Journal Article

High normal levels of albuminuria and risk of hypertension in Indo-Asian population

Saleem Jessani, Andrew S. Levey, Nish Chaturvedi and Tazeen H. Jafar

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue suppl_3, pages iii58-iii64
Published in print October 2012 | ISSN: 0931-0509
Published online May 2011 | e-ISSN: 1460-2385 | DOI:
High normal levels of albuminuria and risk of hypertension in Indo-Asian population

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Urine albumin excretion in the high normal range [urine albumin to creatinine ratio (UACR) 10–29 mg/g)] predicts hypertension in European-origin populations. However, the prognostic significance of UACR in the high normal range for incident hypertension is unclear in Indo-Asians. The objective of this study was to examine the relationship of normal to high normal levels of UACR and incident hypertension.


We conducted a nested cohort study within a cluster randomized controlled trial in Pakistan on 1272 normotensive non-diabetic adults aged ≥40 years with UACR <30 mg/g. Incident hypertension was defined as new onset of systolic blood pressure (SBP) ≥140 mmHg or diastolic ≥ 90 mmHg or initiation of antihypertensive therapy.


A total of 920 (72.3%) participants completed the 2-year final follow-up. During this time, 105 (11.4%) developed incident hypertension. In the multivariable model, the odds [95% confidence interval (CI)] for incident hypertension were 2.45(1.21–4.98) for those in the fourth (top) quartile (≥6.1 mg/g) and 2.12 (1.04–4.35) in the third quartile (3.8–6.1 mg/g) compared to those in the lowest quartile (<2.8 mg/g). In addition, a significant interaction between UACR and baseline SBP was observed suggesting that the odds (95% CI) of incident hypertension with UACR were greater at lower baseline SBP (interaction P = 0.044).


High normal levels of albuminuria as measured by UACR predict hypertension in non-diabetic Indo-Asians, and this relationship may be enhanced in individuals with low baseline SBP. Further research is needed to assess the clinical applicability of these findings.

Keywords: albuminuria; ethnicity; hypertension

Journal Article.  5136 words.  Illustrated.

Subjects: Nephrology

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