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Main Article Content
Predictive value of spot urine albumin-to-creatinine ratio for echocardiography-based left ventricular hypertrophy among newly diagnosed hypertensive patients
Abstract
Objective: Studies have reported high prevalence of left ventricular hypertrophy (LVH) among patients with microalbuminuria. Both left ventricular hypertrophy and microalbuminuria (MA) are associated with increased risk of cardiovascular morbidity and mortality. The study aimed to determine the predictive value of spot urine albumin-to-creatinine ratio (ACR) for echocardiography-based LVH in newly diagnosed hypertensive patients.
Methods: LVH was defined as left ventricular mass index (LVMI) of >115g/m2 in males and >95g/m2 in females. Microalbuminuria was defined as ACR >30 mg/g and diagnostic value of MA for LVH assessed using X2 2by2 table and the Receiver Operating Characteristics (ROC) curve plot.
Results: Sixty six (48.5%) males and 70(51.5%) females with a mean age of 44.8(10.5 %) years were studied. Left ventricular hypertrophy was observed in 36.8% while 42.7% had MA. The prevalence of MA in those with LVH was 66%. Microalbuminuria showed a sensitivity of 64% and specificity of 70% for echocardiography (echo) detected LVH, while the positive predictive value (PPV) and negative predictive value (NPV) were 55% and 77% respectively. Diagnostic accuracy of MA for echo LVH was 68% with an odd ratio of 4.1. ROC curve plot revealed an area under the curve of 0.73 at ACR of 36mg/g, improving the sensitivity and NPV to 85.7% and 83.8% respectively.
Conclusion: Microalbuminuria predicts LVH in treatment naïve Nigerian hypertensive patients. This can be used as a surrogate for LVH in outpatient settings, providing vital information for comprehensive management of patients.
Keywords: Hypertension, microalbuminuria, albumin-to-creatinine ratio, left ventricular hypertrophy
