Racial disparity in albuminuria and its association with hypertension prevalence

Background: Albuminuria and hypertension are two major risk factors for cardiovascular and renal diseases; however racial difference in albuminuria and its association with hypertension prevalence have not been fully studied. Methods: Cross-sectional data of 24,949 participants aged 18 years or older were collected from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 conducted by the NCHS. Weighted multiple logistic regression models were conducted by considering sampling design and weights to examine the associations between albuminuria and hypertension in different racial groups. Results: Average age of participants in the study sample was 45.8±0.25 years. 51.0±0.30% were women, 13.7±1.09% were Hispanics, and 11.8±0.86% were non-Hispanic blacks. After adjustment for age, the risk of hypertension increased for participants with older age, higher BMI, diabetes and albuminuria across all three ethnic groups. Microalbuminuria significantly increased the hypertension risk by 1.45 (95% CI [1.17, 1.79]), 2.05 (95% CI [1.49, 2.82]) and 2.78 (95% CI [2.03, 3.82]) times in whites, blacks and Hispanics, respectively; and macroalbuminuria increased by 3.76 (95% CI [2.01, 7.06]), 11.02 (95% CI [4.59, 26.46]) and 4.74 (95% CI [2.29, 9.78]) times. Further analysis showed that the effects of microalbuminuria are significantly higher in blacks and Hispanics than in whites and the effects of macroalbuminuria were not found significantly different among racial groups. Conclusion: There were racial differences in the association between microalbuminuria and hypertension risk among Hispanics, non-Hispanic whites and non-Hispanic blacks. More efforts should be made in hypertension care for Hispanics and blacks with microalbuminuria.