Correlation between Atrial Fibrillation and Microalbuminuria in Hypertensive Patients

Abstract

Microalbuminuria is a marker of generalized endothelial dysfunction and predicts cardiovascular outcome. MAU can be regarded as a marker for vascular disease and appears to determine the prognosis in patients at risk for cardiovascular events. Reduction of UAE by evidence-based treatment with renin-angiotensin system blocking agents is linked to a reduction of cardiovascular events in hypertensive patients. Cardiovascular risk and mortality of these patients are strongly influenced by the associated comorbidities and risk factors. Hypertension is recognized as a common cardiovascular disease and a major risk factor for congestive heart failure, ischemic heart disease, chronic renal failure and stroke. Hypertension is defined as persistent elevation in blood pressure ≥ 140/90 mm Hg. Cardiac damage is a common early complication of hypertension. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and increases the risk of cardiovascular mortality by approximately two-fold, The presence of hypertension accompanied by left ventricular hypertrophy and left atrial chamber dilatation is regarded as a cardiac risk factor for the development of AF, In heart failure patients, new onset of AF can occur in 5–50% of cases depending on the severity of heart failure and is associated with higher heart rates and worse outcomes. This work aims to investigate the relationship between microalbuminuria and atrial fibrillation and to further evaluate whether the heart-rate had possible relationship in hypertensive patients. This study was carried out as an observational cross-sectional study in Kobbri Elkobba military hospital and Ain Shams university Hospital on 400 hypertensive patients after taking informed consent and patients were divided into two groups: Group A 200 hypertensive patients with AF. Group B: 200 hypertensive patients without AF (control group). All patients were subjected to the following: 1) Full history taking. 2) Full clinical examination. 3) Laboratory investigations including:- a. Serum urea and creatinine. b. Fasting blood sugar and 2hours post prandial. c. GFR using Cockcroft formula. d. Semi quantitative dipstick for microalbuminuria. e. Urine analysis. 3-Resting ECG, ECHO. 4-The data which obtained from this study was analysed by using appropriate statistical methods. Our study demonstrated that the prevalence of MAU in hypertensive patients with cardiovascular risk factors is related to heart rate and significantly higher in patients with AF in hypertension, and there is strong correlation between micro-albuminuria and ejection fraction, hypertension, left ventricular hypertrophy, male gender and GFR no correlation with BMI, age and duration of hypertension.