Patients with high blood pressure should be checked for presence of albumin in the urine.

Human serum albumin, which is produced in the liver, is the most abundant protein in human blood plasma. Sometimes, the kidney leaks small amounts of albumin into the urine causing a pathological condition called microalbuminuria (or urine albumin) which means there is there is an abnormally high permeability for albumin in the renal glomerulus ― the capillary network in the kidney that performs the first step of filtering blood.

In a properly functioning body, albumin is not normally present in urine, because it is retained in the bloodstream by the kidneys. Therefore, urine albumin has become an important prognostic marker for kidney disease in hypertension; it can be an indicator of excessive salt intake; and there is accumulating evidence that it may exacerbate uncontrolled blood pressure in hypertensive patients!

Florida State University researchers found that racial differences in the associations of albuminuria with uncontrolled blood pressure among diagnosed hypertensives have not been evaluated. They decided to explore this racial disparity by analyzing data of a total of 6147 diagnosed hypertensive subjects aged 18 years or older, from the 1999-2008 National Health and Nutrition Examination Survey (NHANES).

The researchers found that hypertensive subjects with microalbuminuria and macroalbuminuria “were more likely to have uncontrolled blood pressure and higher average systolic blood pressure (SBP) in all individual racial groups.” Microalbuminuria was associated with isolated uncontrolled SBP in non-Hispanic blacks and whites, and macroalbuminuria was associated with isolated uncontrolled SBP and diastolic BP (DBP) and high average DBP only in non-Hispanic blacks.

Compared with non-Hispanic whites, non-Hispanic blacks and Mexicans had lower associations of microalbuminuria with uncontrolled blood pressure and isolated uncontrolled SBP. Moreover, the association of microalbuminuria with uncontrolled blood pressure was lower in non-Hispanic blacks and Mexicans than in non-Hispanic whites.

They concluded that “health providers need to improve care for mildly elevated albumin excretion rates in non-Hispanic white hypertensive patients while maintaining the quality of care in non-Hispanic blacks and Mexicans.”

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