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Bha acha ya e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
226
O iginal Resea ch A icle
A S udy on he P e alence o Mic oalbuminu ia in Newly De ec ed
Hype ensi e Pa ien s and i s Associa ion wi h Sys olic Blood P essu e
(SBP) and Pulse P essu e (PP)
Ramanuj Bha acha ya1, Subh o Jyo i Mukhe jee2, Pa ami a Bha acha ya3, Chinmoy
Ba ik4
1Senio Residen (Medicine), MBBS, DNB (Gene al Medicine), Depa men o Gene al Medicine, College
o Medicine and Jawaha lal Neh u Memo ial Hospi al, Kalyani, Wes Bengal 741235
2Senio Residen (Medicine), MBBBS, Doc o o Medicine (Gene al Medicine), Depa men o Gene al
Medicine, College o Medicine and Jawaha lal Neh u Memo ial Hospi al. Kalyani, Nadia
3Assis an P o esso , MBBS, DNB (Gene al Medicine). Depa men o Gene al Medicine, College o
Medicine and Jawaha lal Neh u Memo ial Hospi al, Kalyani, Wes Bengal 741235
4P o esso Gene al Medicine, MBBS, Doc o o Medicine (Gene al Medicine), Depa men o Gene al
Medicine, College o Medicine and Jawaha lal Neh u Memo ial Hospi al, Kalyani, Wes Bengal 741235
Recei ed: 01-06-2025 / Re ised: 16-07-2025 / Accep ed: 28-08-2025
Co esponding Au ho : D . Chinmoy Ba ik
Con lic o in e es : Nil
Abs ac
In oduc ion: One o he main isk ac o s o ca dio ascula mo bidi y and mo ali y and enal dys unc ion is
Hype ension, which is a se ious global heal h conce n. Ea ly on, he illness is equen ly asymp oma ic, bu i
is linked o g adual ha m o impo an o gans such as he b ain, e ina, kidneys, and hea . P e en a ion o long
e m complica ions equi es ea ly de ec ion o hype ension and diagnosis o subclinical o gan damage.
Aims: To de ec he P esence and le els o Mic o albumin in u ine (Spo U ine ACR 30-300) in newly de ec ed
Hype ensi e pa ien s (>=140/90mm o Hg) and i s associa ion wi h Sys olic Blood P essu e(SBP) and Pulse
P essu e(PP) a ending Ou Pa ien Depa men (OPD) and admi ed in Indoo pa ien Depa men (IPD) o
Medicine Dep . O COMJNM&H. Kalyani Nadia, Wes Bengal.
Ma e ials & Me hods: The s udy was designed as an obse a ional c oss-sec ional s udy and was conduc ed in
he Depa men o Medicine, JNM College o Medicine, Wes Bengal, o e a pe iod o one yea , om
Decembe 2019 o Decembe 2020, wi h a o al sample size o 124 pa ien s.
Resul : In ou s udy, The mean ± SD o pulse p essu e was 59.05 ± 9.46 mmHg in pa ien s wi hou
mic oalbuminu ia and 70.77 ± 12.52 mmHg in hose wi h mic oalbuminu ia, showing a s a is ically signi ican
di e ence (P < 0.0001).
Conclusion: In ou s udy, mic oalbuminu ia was p esen in 21% o newly diagnosed hype ensi e pa ien s,
mos commonly in he 41–50-yea age g oup, wi h a male p eponde ance bu no signi ican gende di e ence. I
showed s ong associa ions wi h smoking, ele a ed pulse p essu e, impai ed as ing blood suga , and abno mal
ECG indings, indica ing ea ly a ge o gan in ol emen . These indings emphasize he impo ance o ou ine
sc eening o mic oalbuminu ia in newly diagnosed hype ension o ea ly isk assessmen and p e en ion o
ca dio ascula mo bidi y.
Keywo ds: Mic oalbuminu ia, SBP, ACR, Ca dio ascula Risk And Renal Dys unc ion.
This is an Open Access a icle ha uses a unding model which does no cha ge eade s o hei ins i u ions o access and dis ibu ed unde
he e ms o he C ea i e Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0) and he Budapes Open Access
Ini ia i e (h p://www.budapes openaccessini ia i e.o g/ ead), which pe mi un es ic ed use, dis ibu ion, and ep oduc ion in any medium,
p o ided o iginal wo k is p ope ly c edi ed.
In oduc ion
Hype ension is one o he es ablished isk ac o s
o ca dio ascula mo ali y and mo bidi y. Ea ly
on he illness is equen ly asymp oma ic bu in he
long e m uncon olled Hype ension causes ha m
o impo an o gans such as b ain, e ina, kidneys,
hea . P e en ion o long e m complica ions o
Hype ension equi es ea ly diagnosis o he
subclinical a ge o gan damage. Among nume ous
indica o s, mic oalbuminu ia has eme ged as an
impo an p edic o o bo h enal and
ca dio ascula isk [1].An ea ly sign o enal
endo helial dys unc ion is mic oalbuminu ia, which
is cha ac e ized by u ina y albumin exc e ion o
30–300 mg/day o an albumin- o-c ea inine a io
(ACR) o 30–300 mg/g in spo u ine [2]. I deno es
inc eased glome ula basemen memb ane
pe meabili y, which equen ly happens as a esul
o ch onically ele a ed blood p essu e and ascula
damage. Mic oalbuminu ia has been ound o be
an independen isk ac o o myoca dial
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Bha acha ya e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
227
in a c ion, s oke, and ca dio ascula dea h in
addi ion o being a sign o enal disease [3].
The e o e, i is essen ial o de ec mic oalbuminu ia
in newly diagnosed Hype ensi e pa ien s in o de
o in e ene p omp ly. Mic oalbuminu ia and
Hype ension ha e a complex in e ac ion.
Inc eased enal ascula p essu e and endo helial
damage a e la gely caused by ele a ed sys olic
blood p essu e (SBP) and widening pulse p essu e
(PP) in pa icula [4].Compa ed o dias olic blood
p essu e (DBP), SBP is hough o be a mo e
eliable indica o o ca dio ascula and enal
p oblems. Addi ionally, a e ial s i ness and
ascula age a e e lec ed in pulse p essu e, which
is he di e ence be ween sys olic and dias olic
p essu es. These ac o s also lead o mic o ascula
inju y and albuminu ia [5]. E alua ing he
ela ionship be ween mic oalbuminu ia, sys olic
blood p essu e (SBP), and pulse p essu e (PP)
p o ides aluable insigh s in o ea ly hype ensi e
end-o gan damage. Se e al epidemiological s udies
ha e shown ha mic oalbuminu ia is common
among indi iduals wi h hype ension, wi h
p e alence a es anging om 15% o 40%,
depending on he s udy popula ion, u ine collec ion
me hods, and p esence o como bidi ies such as
diabe es o obesi y. This s udy aims o assess he
p esence and le els o mic oalbuminu ia (de ined
as spo u ine ACR 30–300 mg/g) in newly
diagnosed hype ensi e pa ien s (SBP ≥140 mmHg
and/o DBP ≥90 mmHg), and o examine i s
associa ion wi h SBP and PP. The s udy popula ion
includes pa ien s a ending he Ou pa ien
Depa men (OPD) and hose admi ed o he
Inpa ien Depa men (IPD) o he Depa men o
Medicine a COMJNM&H, Kalyani, Nadia, Wes
Bengal.
Ma e ials and Me hods
Type o s udy: Obse a ional c oss sec ional s udy
Place o s udy: Depa men o medicine, JNM
college o medicine, Wes Bengal.
S udy Du a ion: F om Decembe 2019 o
Decembe 2020.
Sample Size: 124 Hype ensi epa ien s.
Inclusion C i e ia
All Newly De ec ed Hype ensi e Pa ien s who
ga e in o med Consen o he s udy.
Exclusion C i e ia
• On An i-Hype ensi e Medica ions.
• Known case o Type 2 (T2) DM
• Known case o CKD, AKI, Hema u ia, any
bladde Pa hology.
• U ina y T ac In ec ions (UTI), any acu e
eb ile illness.
• A e s enuous exe cise.
• P egnan and Mens ua ing Female.
S udy Va iables
• Age
• Sex
• Mic oalbuminu ia s a us
• U ine ACR
• Sys olic Blood P essu e
• FBS
• ECG indings
S a is ical Analysis: Da a we e en e ed in o Excel
and analyzed using SPSS and G aphPad P ism.
Nume ical a iables we e summa ized using means
and s anda d de ia ions, while ca ego ical a iables
we e desc ibed wi h coun s and pe cen ages.
Two-sample - es s we e used o compa e
independen g oups, while pai ed - es s accoun ed
o co ela ions in pai ed da a. Chi-squa e es s
(including Fishe ’s exac es o small sample
sizes) we e used o ca ego ical da a compa isons.
P- alues ≤ 0.05 we e conside ed s a is ically
signi ican .
Resul
Table 1: Associa ion be ween Age in g oup: Mic oalbuminu ia
Age in g oup
Absen
P esen
To al
P- alue
≤40
15(15.3%)
4(15.4%)
19(15.3%)
0.0323
41-50
41(41.8%)
3(11.5%)
44(35.5%)
51-60
30(30.6%)
12(46.2%)
42(33.9%)
61-70
11(11.2%)
7(26.9%)
18(14.5%)
71-80
1(1%)
0(0%)
1(100%)
To al
98(100%)
26(100%)
124(100%)
Table 2: Associa ion be ween Sex: Mic oalbuminu ia
Sex
Absen
P esen
To al
P- alue
Female
47(48%)
10(38.5%)
57(46.0%)
0.3876
Male
51(52%)
16(61.5%)
67(54.0%)
To al
98(100%)
26(100%)
124(100%)
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Table 3: Associa ion be ween Smoking: Mic oalbuminu ia
Smoking
Absen
P esen
To al
P- alue
No
66(67.3%)
12(46.2%)
78(62.9%)
0.0467
Yes
32(32.7%)
14(53.8%)
46(37.1%)
To al
98(100%)
26(100%)
124(100%)
Table 4: Associa ion be ween ECG Findings: Mic oalbuminu ia
ECG Findings
Absen
P esen
To al
P- alue
LVH
0(0%)
11(42.3%)
11(8.9%)
<0.0001
LVH, T↓
0(0%)
2(7.7%)
2(1.6%)
SB
5(5.1%)
1(3.8%)
6(4.8%)
ST↓, T↓
3(3.1%)
1(3.8%)
4(3.2%)
T↓
13(13.3%)
6(23.1%)
19(15.3%)
WNL
77(78.6%)
5(19.2%)
82(66.1%)
To al
98(100%)
26(100%)
124(100%)
Table 5: Dis ibu ion o mean SBP,DBP, FBS,TLC andPulse P essu e: Mic oalbuminu ia
Numbe
Mean
SD
Minimum
Maximum
Median
p- alue
SBP
Absen
98
150.418
6.5957
140
168
150
<0.0001
P esen
26
164.308
12.1943
146
186
166
DBP
Absen
98
91.3673
6.7814
30
100
92
0.114
P esen
26
93.5385
2.8458
90
100
94
FBS
Absen
98
93.7653
7.8515
68
112
94
<0.0001
P esen
26
110.192
10.5679
90
125
111
TLC
Absen
98
6968.37
1258.593
4600
10600
7200
0.1275
P esen
26
7400
1336.563
4600
9600
7400
Pulse P essu e
Absen
98
69.5918
4.2689
62
84
68
<0.0001
P esen
26
77.8846
8.5057
62
88
80
Figu e 1: Associa ion be ween ECG Findings: Mic oalbuminu ia
Figu e 2: Dis ibu ion o mean SBP: Mic oalbuminu ia
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229
Figu e 3: Dis ibu ion o mean DBP: Mic oalbuminu ia
Figu e 4: Dis ibu ion o mean Pulse P essu e: Mic oalbuminu ia
In ou s udy, among pa ien s wi hou
mic oalbuminu ia, 15 pa ien s (15.3%) we e aged
≤40 yea s, 41 pa ien s (41.8%) we e 41–50 yea s,
30 pa ien s (30.6%) we e 51–60 yea s, 11 pa ien s
(11.2%) we e 61–70 yea s, and 1 pa ien (1%) was
71–80 yea s. In he mic oalbuminu ia g oup, 4
pa ien s (15.4%) we e ≤40 yea s, 3 pa ien s
(11.5%) we e 41–50 yea s, 12 pa ien s (46.2%)
we e 51–60 yea s, 7 pa ien s (26.9%) we e 61–70
yea s, and none (0%) we e 71–80 yea s. The age
dis ibu ion be ween he g oups was s a is ically
signi ican (P = 0.0323). In ou s udy, among
pa ien s wi hou mic oalbuminu ia, 47 pa ien s
(48%) we e emale and 51 pa ien s (52%) we e
male. In wi h mic oalbuminu ia g oup, 10 pa ien s
(38.5%) we e emale and 16 pa ien s (61.5%) we e
male. The di e ence in sex dis ibu ion be ween
he g oups was no s a is ically signi ican (P =
0.3876). In ou s udy, among pa ien s wi hou
mic oalbuminu ia, 66 (67.3%) we e non-smoke s
and 32 (32.7%) we e smoke s, whe eas in he
mic oalbuminu ia g oup, 12 (46.2%) we e non-
smoke s and 14 (53.8%) we e smoke s, and i was
s a is ically signi ican (p = 0.0467).In ou s udy,
among pa ien s wi hou mic oalbuminu ia, ECG
indings we e wi hin no mal limi s in 77 pa ien s
(78.6%), T-wa e changes in 13 pa ien s (13.3%),
ST↓/T↓ changes in 3 pa ien s (3.1%), and sinus
b adyca dia in 5 pa ien s (5.1%); none o he
pa ien s had LVH o LVH wi h T↓. In he
mic oalbuminu ia g oup, 11 pa ien s (42.3%) had
LVH, 2 pa ien s (7.7%) had LVH wi h T↓, 6
pa ien s (23.1%) had T-wa e changes, 1 pa ien
(3.8%) had ST↓/T↓, 1 pa ien (3.8%) had sinus
b adyca dia, and 5 pa ien s (19.2%) we e wi hin
no mal limi s. The di e ence in ECG indings
be ween he g oups was highly signi ican (P <
0.0001). In ou s udy, sys olic blood p essu e (SBP)
in pa ien s wi hou mic oalbuminu ia was 150.42 ±
6.60 mmHg, while in he mic oalbuminu ia g oup
i was 164.31 ± 12.19 mmHg, showing a
s a is ically signi ican di e ence (P < 0.0001). The
mean ± SD o dias olic blood p essu e (DBP) was
91.37 ± 6.78 mmHg in he absen g oup and 93.54
± 2.85 mmHg in he p esen g oup, which was no
s a is ically signi ican (P = 0.114). Fas ing blood
suga (FBS) was signi ican ly highe in he
mic oalbuminu ia g oup, wi h a mean ± SD o
110.19 ± 10.57 mg/dL compa ed o 93.77 ± 7.85
mg/dL in pa ien s wi hou mic oalbuminu ia (P <
0.0001). To al leukocy e coun (TLC) was 6968.37
± 1258.59 /mm³ in he absen g oup and 7400 ±
1336.56 /mm³ in he p esen g oup, wi h no
s a is ically signi ican di e ence (P = 0.1275).In
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230
ou s udy he mean pulse p essu e was 69.59 ± 4.27
mmHg in he wi hou mic oalbuminu ia g oup and
77.88 ± 8.51 mmHg in he mic oalbuminu ia
g oup, wi h a highly signi ican (p < 0.0001).
Discussion
In ou s udy, ou o 124 pa ien s mos o he
pa ien s we e 41-50 yea s old [44 (35.5%)] bu his
was no s a is ically signi ican (p=0.0323).In
simila s udy by Reddy NL e al [6] (2022) showed
ha indi iduals aged 41–50 comp ised a signi ican
po ion o pa ien s wi h mic oalbuminu ia, hough
he associa ion was no s a is ically signi ican .
We ound ha , male popula ion was highe [67
(54.0%)] han he emale popula ion [57 (46.0%)].
Male: Female a io was 1.1:1 bu his was no
s a is ically signi ican (p=0.3876).In o he s udy
by Khan TM e al [7] (2022) obse ed ha highe
equency o mic oalbuminu ia among males,
al hough wi h a iable signi icance ac oss
subg oups and also Poin e MA e al [8] (2015)
showed ha males we e mo e likely han emales o
de elop mic oalbuminu ia in p ediabe es, being 2.5
imes mo e likely despi e compa able glycemic
s a us.
We ound ha , smoking was signi ican ly mo e
common in wi h mic oalbuminu ia g oup, seen in
14 pa ien s (53.8%), compa ed o 32 pa ien s
(32.7%) in he wi hou mic oalbuminu ia g oup,
and i was s a is ically signi ican (p = 0.0467).
We obse ed ha ECG wi hin WNL was highes in
pa ien s wi hou mic oalbuminu ia g oup seen in 77
pa ien s (78.6%), and i was much lowe in he wi h
mic oalbuminu ia g oup, obse ed in only 5
pa ien s (19.2%). This di e ence was highly
signi ican (P < 0.0001).In o he s udy by Shi Ye
al [9] (2022) obse ed ha pa ien s wi h
albuminu ia had nea ly double he equency o
abno mal ECG pa e ns compa ed o hose wi hou
albuminu ia (62% s 31%).
We ound ha he sys olic blood p essu e (SBP)
was highe in he mic oalbuminu ia g oup (164.31
± 12.19 mmHg) compa ed o hose wi hou
mic oalbuminu ia (150.42 ± 6.60 mmHg), showing
a highly signi ican di e ence (P < 0.0001). The
dias olic blood p essu e (DBP) was also sligh ly
highe in he mic oalbuminu ia g oup (93.54 ± 2.85
mmHg) han in he absen g oup (91.37 ± 6.78
mmHg), hough no s a is ically signi ican (P =
0.114). Fas ing blood suga (FBS) was signi ican ly
highe in he mic oalbuminu ia g oup (110.19 ±
10.57 mg/dL) compa ed o he absen g oup (93.77
± 7.85 mg/dL) (P < 0.0001). To al leukocy e coun
(TLC) was also highe in he mic oalbuminu ia
g oup (7400 ± 1336.56 /mm³) han in hose wi hou
mic oalbuminu ia (6968.37 ± 1258.59 /mm³), bu
he di e ence was no s a is ically signi ican (P =
0.1275).Pulse p essu e was signi ican ly highe in
he mic oalbuminu ia g oup (77.88 ± 8.51 mmHg)
compa ed o he wi hou mic oalbuminu ia g oup
(69.59 ± 4.27 mmHg), and his di e ence was
highly signi ican (p < 0.0001).In simila s udy by
Hellemons ME e al [10] (2011) obse ed ha
mic oalbuminu ia was s ongly associa ed wi h
sys emic in lamma ion, wi h ele a ed leukocy e
coun s and CRP le els among a ec ed indi iduals.
Conclusion
We concluded han MAU (Mic o albuminu ia) was
seen in a conside able pe cen age o newly
diagnosed hype ensi e pa ien s in ou s udy 26
pa ien s ( ha is 21%). Pulse p essu e was mo e in
MAU han wi hou MAU p sas also impai ed
as ing blood suga le els. Mic oalbuminu ia was
seen in a conside able pe cen age o newly
diagnosed Hype ensi e pa ien s in ou s udy; mos
o hese indi iduals we e be ween he ages o 41
and 50. Al hough he e was a male p eponde ance,
he e was no s a is ically signi ican gende
di e ence. Mic oalbuminu ia was s ong
associa ed wi h smoking and Mic oalbuminu ia's
s ong co ela ion wi h me abolic and
ca dio ascula isk ac o s was demons a ed by he
no iceably ele a ed as ing blood suga le els in
pa ien s wi h he condi ion. Pulse p essu e and
as ing blood suga le els we e mo e in pa ien s
wi h mic oalbuminu ia compa e o pa ien s wi hou
mic oalbuminu ia .This g oup also had a much
g ea e a e o abe an ECG eadings, which
sugges s ea ly a ge o gan in ol emen . These
esul s highligh he signi icance o
mic oalbuminu ia as an indica o o ca dio ascula
mo bidi y in pa ien s wi h hype ension. The e o e,
o ea ly isk assessmen , p e en i e measu es, and
imp o ed long- e m esul s, ou ine sc eening o
mic oalbuminu ia in newly diagnosed Hype ensi e
pa ien s is essen ial.
Re e ence
1. Ge s ein HC, Mann JF, Yi Q, Zinman B,
Dinneen SF, Hoogwe B, Hallé JP, Young J,
Rashkow A, Joyce C, Nawaz S. Albuminu ia
and isk o ca dio ascula e en s, dea h, and
hea ailu e in diabe ic and nondiabe ic
indi iduals. Jama. 2001 Jul 25;286(4):421-6.
2. S ehouwe CD, Smulde s YM.
Mic oalbuminu ia and isk o ca dio ascula
disease: analysis o po en ial mechanisms.
Jou nal o he Ame ican Socie y o
Neph ology. 2006 Aug 1;17(8):2106-11.
3. Klausen K, Bo ch-Johnsen K, Feld -
Rasmussen B, Jensen G, Clausen P, Scha ling
H, Appleya d M, Jensen JS. Ve y low le els o
mic oalbuminu ia a e associa ed wi h
inc eased isk o co ona y hea disease and
dea h independen ly o enal unc ion,
hype ension, and diabe es. Ci cula ion. 2004
Jul 6;110(1):32-5.
In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch e-ISSN: 0976-822X, p-ISSN: 2961-6042
Bha acha ya e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
231
4. Ve decchia P, Schillaci G, Bo gioni C, Ciucci
A, Pede S, Po cella i C. Ambula o y pulse
p essu e: a po en p edic o o o al
ca dio ascula isk in hype ension.
Hype ension. 1998 Dec;32(6):983-8.
5. F anklin SS, Gus in IV W, Wong ND, La son
MG, Webe MA, Kannel WB, Le y D.
Hemodynamic pa e ns o age- ela ed changes
in blood p essu e: he F amingham Hea
S udy. Ci cula ion. 1997 Jul 1;96(1):308-15.
6. Reddy NL, Kalakonda VR, Rahul NS,
Busapogula DK. P e alence o
mic oalbuminu ia in newly diagnosed ype 2
diabe es melli us and associa ion wi h o he
isk ac o s. In e na ional jou nal o heal h
sciences. 2022;6(S6):1818-25.
7. Khan TM, Nawaz FK, Ka im MS, Sha ique Z,
Anwa MS, Usman O. Incidence o
mic oalbuminu ia and ac o s a ec ing i in
pa ien s wi h ype 2 diabe es melli us. Cu eus.
2022 Jul 26;14(7).
8. Poin e MA, Hicks K, Williams-De ane C,
Wells C, G eene N. Gende di e ences in
p eclinical ma ke s o kidney inju y in a u al
No h Ca olina A ican-Ame ican coho .
F on ie s in Public Heal h. 2015 Jan 26;3:7.
9. Shi Y, Hu H, Wu Z, Wu J, Chen Z, Li P. Sex
modi ies he associa ion be ween u ina y
albumin- o-c ea inine a io and diabe es among
adul s in he Uni ed S a es (NHANES 2011–
2018). Biology o sex Di e ences. 2022 Sep
30;13(1):53.
10. Hellemons ME, Pe sson F, Bakke SJ, Rossing
P, Pa ing HH, De Zeeuw D, Lambe s
Hee spink HJ. Ini ial angio ensin ecep o
blockade–induced dec ease in albuminu ia is
associa ed wi h long- e m enal ou come in
ype 2 diabe ic pa ien s wi h mic oalbuminu ia:
a pos hoc analysis o he IRMA-2 ial.
Diabe es Ca e. 2011 Sep 1;34(9):2078-83.
