P-525: Effects of smoking on albuminuria in hypertensives with metabolic syndrome

Abstract

Metabolic syndrome (MS) is associated with insulin resistance and increased cardiovascular risk. The incidence of endothelial dysfunction as assessed by microalbuminuria and the role of smoking in hypertensive patients (pts) with MS have not been investigated.

We studied retrospectively 6013 consecutive pts with chronic uncomplicated essential hypertension. MS was diagnosed according to Adult Treatment Panel III criteria, and smoking status was noted. After a two-week wash-out period, office blood pressure (BP) was determined and full biochemical evaluation performed. Microalbumin, alpha₁-microglobulin and creatinine were measured and the albumin/creatinine ratio (ACR) was calculated after a 24-hour urine collection.

Pts with MS (n=2183) had significantly (p<0.00001) increased values of microalbumin, alpha₁-microglobulin and ACR (39.0 vs 24.2 mg/l, 8.80 vs 6.72 mg/l and 85.5 vs 47.3 respectively) and higher incidence of smoking (44.0 vs 30.0%, p<0.00001) when compared with hypertensives without MS. Smokers without MS (n=1146) had significantly increased microalbumin, alpha₁-microglobulin and ACR than non-smokers without MS (27.2 vs 22.9 mg/l, p<0.00001, 7.28 vs 6.49 mg/l, p<0.00001 and 49.0 vs 46.5, p=0.006 respectively). Respectively, in the MS group, smokers (n=958) had increased levels of microalbumin (42.3 vs 36.5 mg/l, p=0.006), alpha₁-microglobulin (9.11 vs 8.55 mg/l, p=0.009) and ACR (96.5 vs 76.1 mg/l, p<0.00001) when compared to the 1224 non-smokers with MS.

The metabolic syndrome is associated with a higher degree of endothelial dysfunction in hypertensive pts, since microalbuminuria is a marker of endothelial performance. It seems that smoking is accompanied by further endothelial derangement, even in hypertensives with MS.

Metabolic Syndrome, Microalbuminuria, Smoking