ABSTRACT
Introduction The adverse effects of systemic hypertension on target organs are widespread and thus lead to a varying degree of macrovascular and microvascular damage. The relationships of blood pressure (BP) with various indexes of target organ damage (TOD) are complex and have not been well described. With the increased availability of ambulatory and home BP measurements, these relationships have become more conveniently assessed and compared with that of office BP measurements. Indeed, a positive correlation has been shown between various BP components (24-hour, daytime, night-time, systolic BP [SBP] and diastolic BP) and microalbuminuria or increased left ventricular (LV) mass. Furthermore, the relationship between microalbuminuria and atherosclerotic processes are also tightly related and increased urinary albumin excretion has been considered a marker of prevalent subclinical atherosclerosis. Indeed, patients who have elevated urinary albumin excretion are more likely to exhibit increased LV mass and LV hypertrophy (LVH), demonstrating more carotid plaque or intima-media thickness and retinal major vascular changes. Such a relationship is particularly strong for coronary artery disease as microalbuminuria has been shown to be the most potent independent determinant of ischaemic heart disease especially among the hypertensive or borderline hypertensive subjects.
