Microalbuminuria in hypertensive patients: evaluation of one-year treatment with irbesartan.

BACKGROUND Microalbuminuria is an important cardiovascular risk factor, and appears to be a marker of early arterial disease in patients with and without diabetes and/or hypertension. The aim of this study was to investigate prevalence of albuminuria in hypertensive patients in clinical settings, as well as to assess the efficacy of the angiotensin receptor blocker irbesartan on the evolution of this risk marker in habitual clinical practice. METHODS KORAL-HT is a prospective, multicenter 1-year follow-up study in inadequately controlled hypertensive patients. Demographic data, major cardiovascular risk factors, albuminuria, and clinical parameters were recorded at baseline and at 6-month and 12-month visits. During the year of follow-up, the patients received antihypertensive therapy with irbesartan in addition to their usual antihypertensive regimen. RESULTS A total of 1657 [802 diabetics (48.4%) and 855 nondiabetics (51.6%)] hypertensive patients were studied. The prevalence of microalbuminuria in this sample was 62.5%. After 1-year treatment with irbesartan, the percentage of patients with normoalbuminuria grew from 17.1% at baseline to 40.9% at 1-year follow-up. Blood pressure (BP) decreased from 157.3 +/- 13.7/93.6 +/- 9.2 mm Hg at baseline to 139.8 +/- 13.12 mm Hg and 136.1 +/- 11.6/80.1 +/- 8 mmHg at 6- and 12-month visits, respectively. The percentage of patients who achieved BP targets increased progressively, 57.2% at 6 months, and 70.1% at the study end. CONCLUSION This study shows that the population attending Spanish HT centers have high prevalence of microalbuminuria. The addition of irbesartan to the usual treatment in poorly controlled hypertensive patients significantly improved BP control, and reduced microalbuminuria both in diabetic and nondiabetic patients. Our study confirms that similar results can be obtained in normal clinical practice as in controlled clinical trials.