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Urine albumin-to-creatinine ratio and asymptomatic intracranial atherosclerotic stenosis in hypertensive patients

Journal of Human Hypertension volume 33, pages 482–488 (2019)Cite this article

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Abstract

Intracranial atherosclerotic stenosis (ICAS) contributes to nearly 50% of stroke in China, especially in patients with hypertension. Urine albumin-to-creatinine ratio (ACR) has been related to stroke and other atherosclerotic cardiovascular diseases. However, there is limited information about the association of ACR and early impairment of cerebral vessels. Hereby we assessed the association of ICAS with ACR, estimated glomerular filtration rate (eGFR), and dipstick proteinuria in a stroke-free hypertensive population. We included 889 hypertension patients aged ≥60 years without prior stroke. Computed tomography angiography was performed to detect ICAS. ACR and dipstick proteinuria were tested from a random spot urine. eGFR was calculated using the CKD-EPI equation. Logistic regression was carried out to analyze the association of renal function with the presence, extent, and lesion number of ICAS. Elevated ACR (≥30 mg/g) was associated with ICAS after adjustment of confounding factors (odds ratio (OR) = 1.66, 95% confidence interval (CI): 1.21–2.29). Patients with elevated ACR were more prone to develop moderate-to-severe stenosis (OR = 1.57, 95% CI: 1.16–2.14) and more lesions (OR = 1.58, 95% CI: 1.16–2.15). Such association was independent of previously identified cardiovascular risk factors. No significant association was detected between ICAS and dipstick proteinuria or eGFR after adjustment. Our findings suggested that elevated ACR was associated with asymptomatic ICAS in an aged stroke-free hypertensive population.

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Funding

The project was supported by grants from the National Natural Science Foundation of China (81670213, 81370205, and 81000037), National Key Program for Basic Research (2009CB521905), Shanghai Municipal Health Bureau Foundation (201640243), and Natural Science Foundation of Minhang District (2014MHZ060). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.

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  1. Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Dewei An, Yan Wang, Yan Li & Dingliang Zhu

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  1. Dewei An
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Correspondence to Yan Wang or Dingliang Zhu.

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An, D., Wang, Y., Li, Y. et al. Urine albumin-to-creatinine ratio and asymptomatic intracranial atherosclerotic stenosis in hypertensive patients. J Hum Hypertens 33, 482–488 (2019). https://doi.org/10.1038/s41371-019-0201-3

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