Correlation of systolic blood pressure and pulse pressure with albuminuria in patients of hypertension without diabetes
DOI:
https://doi.org/10.63341/bmbr/2.2025.80Keywords:
renal dysfunction, cardiovascular disease, urine albumin-to-creatinine ratio, nephropathyAbstract
Hypertension and microalbuminuria (MAU) are independent yet interconnected markers of cardiovascular and renal dysfunction. While MAU is an early indicator of renal impairment, its relationship with blood pressure (BP) components, particularly systolic blood pressure (SBP) and pulse pressure (PP), remains underexplored in non-diabetic hypertensive populations. The purpose of this study was to investigate the independent association between these BP components and MAU, identify which parameter exhibits a stronger correlation, and enhance the understanding of early renal dysfunction in hypertension management. For this analytical cross-sectional study was conducted at Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, over 12 months, involving 120 hypertensive patients attending outpatient and inpatient departments. Patients with comorbidities like diabetes mellitus, renal failure, or overt proteinuria were excluded. BP was measured in two separate readings using a standard sphygmomanometer, and microalbuminuria was assessed via immunoturbidometric assay. The urine albumin-to-creatinine ratio (ACR) served as the primary indicator of MAU. SBP and PP demonstrated significant positive correlations with MAU (ρ = 0.25, p = 0.032; ρ = 0.30, p = 0.015, respectively), while diastolic BP (DBP) showed a negative yet non-significant association (ρ = -0.20, p = 0.065). Among anthropometric parameters, body mass index (BMI) and waist-hip ratio exhibited no significant differences between groups. Urine ACR was markedly higher in the MAU group (182.5 ± 156.5 mg/L) compared to the non-MAU group (17.6 ± 7.1 mg/L; p < 0.0001). Lipid profiles, fasting blood glucose, and renal function markers like serum creatinine and blood urea nitrogen were comparable between groups, highlighting BP components as primary predictors of albuminuria. The strong positive correlations between SBP, PP, and MAU highlighted the need for precise BP management in non-diabetic hypertensive patients. Regular monitoring and treatment to optimise SBP and PP levels could mitigate renal damage and reduce cardiovascular risks
Received: 16.01.2025 | Revised: 22.04.2025 | Accepted: 27.05.2025
References
Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int. 2021;99(3):1–87. DOI: 10.1016/j.kint.2020.11.003
Zhang W, Liu CY, Ji LN, Wang JG. Blood pressure and glucose control and the prevalence of albuminuria and left ventricular hypertrophy in patients with hypertension and diabetes. J Clin Hypertens. 2020;22(2):212–20. DOI: 10.1111/jch.13793
Coşkun Ş, Cordan J, Mehmetoğlu E, Sağ S, Yeşilbursa D, Serdar OA, et al. Association between microalbuminuria and pulse pressure among patients with isolated systolic and diastolic hypertension. J Updates Cardiovasc Med. 2021;9(1):39–48. DOI: 10.32596/ejcm.galenos.2020-10-056
Liu L, Wu X, Tang Q, Miao Y, Bai X, Li J, et al. Positive association of pulse pressure with presence of albuminuria in Chinese adults with prediabetes: A community-based study. Metab Syndr Relat Disord. 2024;22(4):302–14. DOI: 10.1089/met.2023.0177
Sołtysiak J, Skowrońska B, Maćkowiak-Lewandowicz K, Blumczyński A, Elżbieta K, Ostalska-Nowicka D, et al. Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus. Pediatr Nephrol. 2024;39(10):3037–47. DOI: 10.1007/s00467-024-06416-3
Suzuki D, Hoshide S, Kario K. Associations between day-by-day home blood pressure variability and renal function and albuminuria in patients with and without diabetes. Am J Hypertens. 2020;33(9):860–8. DOI: 10.1093/ajh/hpaa091
Durak BA, Durak Mİ, Özbakkaloğlu A. The relationship between proteinuria and ambulatory blood pressure in hypertensive patients. Cardiovasc Surg Int. 2025;12(1):28–35. DOI: 10.5606/e-cvsi.2025.1775
Rossi GP, Bisogni V, Rossitto G, Maiolino G, Cesari M, Zhu R, et al. Practice recommendations for diagnosis and treatment of the most common forms of secondary hypertension. High Blood Press Cardiovasc Prev. 2020;27(6):547–60. DOI: 10.1007/s40292-020-00415-9
Lamirault G, Artifoni M, Daniel M, Barber-Chamoux N. Resistant hypertension: Novel insights. Curr Hypertens Rev. 2020;16(1):61–72. DOI: 10.2174/1573402115666191011111402
The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. [cited 2024 November 28]. Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/
Song J, Wang P, Li H. U-shaped relationship between fasting blood glucose and urinary albumin-to-creatinine ratio in the general United States population. Front Endocrinol. 2024;15:1334949. DOI: 10.3389/fendo.2024.1334949
Yimthiang S, Pouyfung P, Khamphaya T, Kuraeiad S, Wongrith P, Vesey DA, et al. Effects of environmental exposure to cadmium and lead on the risks of diabetes and kidney dysfunction. Int J Environ Res Public Health. 2022;19(4):2259. DOI: 10.3390/ijerph19042259
Chandie Shaw PK, Berger SP, Mallat M, Frölich M, Dekker FW, Rabelink TJ. Central obesity is an independent risk factor for albuminuria in nondiabetic South Asian subjects. Diabetes Care. 2007;30(7):1840–4. DOI: 10.2337/dc07-0028
Lei B, Nakano D, Fan YY, Kitada K, Hitomi H, Kobori H, et al. Add-on aliskiren elicits stronger renoprotection than high-dose valsartan in type 2 diabetic KKAy mice that do not respond to low-dose valsartan. J Pharmacol Sci. 2012;119(2):131–8. DOI: 10.1254/jphs.12031fp
Coca SG, Ismail-Beigi F, Haq N, Krumholz HM, Parikh CR. Role of intensive glucose control in development of renal end points in type 2 diabetes mellitus: Systematic review and meta-analysis intensive glucose control in type 2 diabetes. Arch Internal Med. 2012;172(10):761–9. DOI: 10.1001/archinternmed.2011.2230
Ahmed Aziz KM. Association of high levels of spot urine protein with high blood pressure, mean arterial pressure and pulse pressure with the development of diabetic chronic kidney dysfunction or failure among diabetic patients. Statistical regression modeling to predict diabetic proteinuria. Curr Diabetes Rev. 2019;15(6):486–96. DOI: 10.2174/1573399814666180924114041
Bhusal KR, Devkota S, Pathak S, Khanal P, Khanal U, Thapalia P, et al. Prevalence of microalbuminuria in non-diabetic hypertensive patients and its correlation with changes in left ventricular and left atrial characteristics. J Nepal Health Res Counc. 2023;20(4):838–41. DOI: 10.33314/jnhrc.v20i4.3786
Thieme K, Oliveira-Souza M. Renal hemodynamic and morphological changes after 7 and 28 days of leptin treatment: The participation of angiotensin II via the AT1 receptor. PLoS One. 2015;10(3):e0122265. DOI: 10.1371/journal.pone.0122265
Lee E, Oh HJ, Park JT, Han SH, Ryu DR, Kang SW, et al. The incidence of cardiovascular events is comparable between normoalbuminuric and albuminuric diabetic patients with chronic kidney disease. Medicine. 2016;95(15):e3175. DOI: 10.1097/MD.0000000000003175
Xie N, Li X, Zhong Q, Zhou D, Cai A, Zhang Y, et al. Association of systolic blood pressure and pulse pressure with microalbuminuria in treatment-naïve hypertensive patients. Arch Med Sci. 2019;15(4):832–6. DOI: 10.5114/aoms.2018.77727
Kim BJ, Lee HJ, Sung KC, Kim BS, Kang JH, Lee MH, et al. Comparison of microalbuminuria in 2 blood pressure categories of pre hypertensive subjects. Circ J. 2007;71(8): 1283–7. DOI: 10.1253/circj.71.1283
Jung YH, Cho AR, Chung TH, Lee YJ. Association between systolic blood pressure and albuminuria in elderly people without type 2 diabetes or chronic kidney disease. Korean J Fam Pract. 2016;6(5):509–13. DOI: 10.21215/kjfp.2016.6.5.509
Bangalore S, Gong Y, Cooper-DeHoff RM, Pepine CJ, Messerli FH. 2014 Eighth Joint National Committee panel recommendation for blood pressure targets revisited: Results from the INVEST study. J Am Coll Cardiol (JACC). 2014;64(8):784–93.
Basu A, Jhala JS. Association of microalbuminuria in non-diabetic and non-hypertensive patients with myocardial infarction. Int J Adv Med. 2015;2(3):196–200. DOI: 10.18203/2349-3933.ijam20150003
Mimarm A. Microalbuminuria in essential hypertension. Clin Exp Hypertens. 1997;19(5–6):753–67. DOI: 10.3109/10641969709083184
Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J, Stamler R, et al. Microalbuminuria in nondiabetic adults. Relation of blood pressure, body mass index, plasma cholesterol levels, and smoking: The Gubbio population study. Arch Intern Med. 1998;158(17):1933–9. DOI: 10.1001/archinte.158.17.1933
Jensen JS, Borch-Johnsen K, Jensen G, Feldt-Rasmussen B. Atherosclerotic risk factors are increased in clinically healthy subjects with microalbuminuria. Atherosclerosis. 1995;112(2):245–52. DOI: 10.1016/0021-9150(94)05420-n
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Bulletin of Medical and Biological Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
