Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population

Methods. A total of 3143 subjects aged >= 40 years from 12 randomly selected communities in Karachi participated. MA was defined as the urine albumin to creatinine (ACR) ratio of < 300 mg/g creatinine and >= 17 mg/g in men and >= 25 mg/g in women from a single-spot morning urine sample. Major changes on ECG were coded in duplicate using Minnesota classification. Results. The mean age of subjects was 51.5 (10.7) years. The median (25-75 percentile) ACR was 4.2 (2.9-7.9) mg/g in men and 6.0 (3.9-10.8) mg/g in women (P < 0.001). The overall prevalence (95% CI) of MA was 12.3% (11.1-13.5%), and 20.3% in those with major ECG changes. In a multivariable model, major ECG changes (OR, 95% CI) (1.50, 1.10-2.00), diabetes (3.57, 2.93-4.35), hypertension (2.30, 1.85-2.86), female sex (0.61, 0.53-0.69), age (1.09, 1.05-1.13, for each 5-year increase) and eGFR (0.80, 0.78-0.81, for each 10 mg/g increase) were independently associated with MA. The presence of MA increased the prevalence of major ECG changes from 21 to 31% in those with hypertension (44.9%), 15 to 28% among those with diabetes (21.4%), 14 to 26% among those with overweight or obesity (68.4%) and 14 to 26% among current users of tobacco (38.7%) (P < 0.001) each. Conclusions. The strong association between MA and major ECG changes underscores the importance of screening Indo-Asian subjects for MA for unmasking underlying CVD, especially those with hypertension, diabetes, obesity, and tobacco users.