Prevalence of microalbuminuria in hypertensive patients and its associated cardiovascular risk in clinical cardiology: Moroccan results of the global i-SEARCH survey - A sub-analysis of a survey with 21 050 patients in 26 countries worldwide

Objectives: To determine the prevalence of microalbuminuria (MAU) in hypertensive outpatients visiting a cardiologist's office or clinic and to describe the relationship between MAU and cardiovascular risk factors. Methods: This was an international, observational, cross-sectional study of 22 282 patients, with 457 subjects from Morocco in 40 cardiology centres. Inclusion criteria were: male and female outpatients aged ≥ 18 years with currently treated or newly diagnosed hypertension (≥ 140/90 mmHg at rest on the day of the study visit) and no reason for false positive microalbuminuria dipstick tests. Outcome measures: Prevalence of microalbuminuria assessed using a dipstick test, co-morbid cardiovascular risk factors or disease and their relationship with the presence of MAU, and role of pharmacotherapy in modulating the prevalence of MAU. Results: The prevalence of microalbuminuria in hypertensive patients in Morocco (67.8%) was high compared to the worldwide prevalence (58.3%). Despite the fact that all physicians regarded MAU as important for risk assessment and therapeutic decisions, routine MAU measurement was performed in only 35% of the practices. In clinical cardiology, MAU is highly correlated with a wide variety of cardiovascular risk factors and cardiovascular disease. While angiotensin receptor blockers (ARBs) appeared to be associated with the lowest risk of MAU, calcium channel blockers (CCBs) were more often used in this patient group. Conclusions: Hypertensive, high-risk cardiovascular patients are common in clinical cardiology. Given the high prevalence detected, screening of MAU in addition to more aggressive multi-factorial treatment to reduce blood pressure as well as other cardiovascular risk factors is required.