Evaluation of global cardiovascular risk in non treated hypertensive patients: Role of microalbuminuria and echocardiogram

European guidelines indicate the importance of the evaluation of global cardiovascular risk to determine the hypertensive patients’ (EH) management . However in primary care the diagnostic work-up only includes an evaluation of the metabolic risk factors but an evaluation of target organ damage is nor routinely performed. The aim of this study was to assess the importance of microalbuminuria (MA) and echocardiogram (ECHO) in the process of risk stratification and consequently in the number of patients to be treated with antihypertensive drugs at diagnosis. One hundred and fifty five non treated EH were included in the study. Blood Pressure (BP) was measured in several visits with a mercury sphygmomanometer and a lipid profile and plasma glucose (LG) were determined in blood samples obtained after an overnight fast. MA was evaluated with reactive dipstick MICRALTEST during 3 consecutive days and in those patients with 2 positive results it was again measured in two 24-hour urine samples and was considered positive (MA+) if the average was > 30 mg/24h. Left ventricular mass index (LVMI) was calculated and values > 125 g/m2 were considered as LV hypertrophy (LVH +). Risk stratification and management were performed following the ESH/ESC 2003 guidelines criteria. 24 (15%) EH were MA+ and 33 (21.3%) were LVH+. The table shows the percentage of patients in the different categories of cardiovascular risk and the number of patients to be treated with the conventional (LG) evaluation and when the results of MA, ECHO and both were considered to evaluate the cardiovascular risk. *p < 0.005 as compared with LG. *p < 0.005 as compared with LG. In conclusion in EH with moderate risk measurement of microalbuminuria, due to its easy availability and low cost, seems to be a cost effective screening test to avoid the underestimation of the cardiovascular risk