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Echocardiographic associations with renal function in hypertensive individuals treated at Primary Care level

INTRODUCTION: Microalbuminuria (MA) and glomerular filtration rate (GFR) can be associated with cardiac complications hypertension (AH), which may lead to changes in the structure, function and left ventricular geometry. OBJECTIVES: To correlate changes of the GFR and MA with the parameters of the left ventricle (LV) assessed by echocardiography. METHODS: A cross-sectional study was carried out from February through July 2010 with 220 hypertensive patients treated at two Primary Care Outpatient Clinics in São Luis. Patients > 18 years of age of both sexes were included in the study. Sociodemographic data, GFR, MA on 24-hour urine, biochemistry and LV geometry and function were assessed. They were divided into two groups according to MA and GFR. RESULTS: The group AH and MA showed increased wall thickness and LV mass indexed for the body surface area (BSA) and relative wall thickness (RWT), lower lateral E' and septal waves, and higher mean E/e' ratio (p <0.05). The AH group with GFR < 60 mL/min/1,73 m² showed increased wall thickness and LV mass indexed for BSA, lower lateral E 'and septal waves, and higher mean E/e' ratio (p < 0.05). The geometric pattern of LV concentric hypertrophy (LVH) was related to MA (p = 0.002). CONCLUSIONS: The MA was significantly associated with increased LV wall thickness and LV mass indexed for BSA, and also changes of diastolic function. Left ventricular concentric hypertrophy was related to MA. The GFR was also significantly associated with increased LV wall thickness and LV mass indexed for BSA suggesting changes of the diastolic function.

Hypertension; Glomerular Filtration Rate; Echocardiography


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