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European Heart Journal Advance Access originally published online on April 21, 2009
European Heart Journal 2009 30(11):1364-1371; doi:10.1093/eurheartj/ehp124
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Atrial fibrillation and heart rate independently correlate to microalbuminuria in hypertensive patients

Michael Böhm1,*,{dagger}, Martin Thoenes2,{dagger}, Hans-Ruprecht Neuberger1,{dagger}, Stefan Gräber3, Jan-Christian Reil1, Peter Bramlage4 and Massimo Volpe5,6

1 Klinik für Innere Medizin III (Kardiologie, Angiologie, Internistische Intensivmedizin), Universität des Saarlandes, Kirrberger Straße, 66424 Homburg/Saar, Germany
2 Sanofi-Aventis, Paris, France
3 Institut für Medizinische Biometrie, Epidemiologie, und Medizinische Informatik, Universität des Saarlandes, Homburg/Saar, Germany
4 Institut für Klinische Pharmakologie, Technische Universität Dresden, Dresden, Germany
5 University of Roma ‘La Sapienza’, S.Andrea Hospital, Roma, Italy
6 IRCCS Neuromed, Pozzilli (IS), Italy

Received 20 June 2008; revised 19 February 2009; accepted 11 March 2009; online publish-ahead-of-print 21 April 2009.

* Corresponding author. Tel: +49 06841 1623372, Fax: +49 06841 1623369, Email: boehm{at}uks.eu

Aims: To investigate the relationship between microalbuminuria (MAU) and atrial fibrillation (AF) and to further evaluate whether the heart rate dependency of MAU in patients without AF is maintained in patients with a history of AF.

Methods and results: The International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH) included 18 900 patients without and 1705 patients with a history of AF suffering from hypertension and other risk factors for cardiovascular disease in 26 countries worldwide from September 2005 to March 2006. Heart rate, blood pressure, urinary albumin excretion, and an estimated glomerular filtration rate were determined among other parameters. The prevalence of MAU was higher at higher heart rate in both patients with and without a history of AF. Prevalence of MAU was about 10% higher in patients with a history of AF (P < 0.001). Male gender, the presence of diabetes mellitus, a higher heart rate, and a higher diastolic blood pressure were independently associated with increased odds for MAU in patients without and with a history of AF.

Conclusion: The prevalence of MAU in hypertensive patients with cardiovascular risk factors is related to heart rate and significantly higher in patients with a history of AF.

Key Words: Atrial fibrillation • Microalbuminuria • Hypertension • Heart rate

{dagger} The first three authors have contributed equally to the work.


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