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

Journal Article (Journal Article)


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.

Full Text

Duke Authors

Cited Authors

  • Jessani, S; Levey, AS; Chaturvedi, N; Jafar, TH

Published Date

  • October 2012

Published In

Volume / Issue

  • 27 Suppl 3 /

Start / End Page

  • iii58 - iii64

PubMed ID

  • 21592974

Pubmed Central ID

  • PMC3634393

Electronic International Standard Serial Number (EISSN)

  • 1460-2385

International Standard Serial Number (ISSN)

  • 0931-0509

Digital Object Identifier (DOI)

  • 10.1093/ndt/gfr200


  • eng